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Stay in sync with Patient Estimates

Published: August 28, 2018 by Experian Health

In the healthcare industry, transparency is everything — you want your patients to be as informed as possible every step of the way. Unfortunately, that doesn’t always happen with pricing, leaving both patients and providers unsure what the final bill is going to be.

That’s where Experian Health’s Patient Estimates tool comes in. With this solution, you can provide your patients with timely, accurate projections of the costs of their care either before or at the point of service. By better preparing patients for their bill, Patient Estimates helps you avoid the underpayment problems you’re likely all too familiar with, leaving you more time to focus on providing the care that really matters.

The power of accuracy

The pricing process in healthcare is complicated. Constantly translating the shifting policies of insurers, suppliers, and partner organizations requires a level of attention that healthcare providers are rarely able to spare. But unless you thoroughly understand all the details that go into a pricing estimate, the only thing you can really offer is speculation. And patients are stressed enough as it is; the last thing they want to worry about is whether their costs are going to unexpectedly skyrocket once the bill comes.

Each projection that comes from the Patient Estimates tool undergoes several data-gathering stages before delivering any results. Patient Estimates collects information from the patient’s insurance provider, including claims history and payer contract terms, as well as the hospital’s chargemaster price. This data is automatically posted to a centralized work list, which can be customized by a healthcare provider depending on its needs.

Imagine you need a price estimate for a patient who needs a common procedure or you’re trying to pinpoint the costs of a very specific procedure. You can narrow your search in the Patient Estimates platform to match your patient’s unique situation, and then you can easily pull that pricing information back up at any time. Most importantly, this data is equally accessible for your patients — you can print estimates in a variety of languages or customize scripts for your staff to read.

As altruistic as this all sounds, Patient Estimates isn’t just a way to fulfill an ever-increasing obligation of state mandates for price transparency. Getting accurate pricing estimates slashes the time you’d spend manually updating pricing lists and scrambling to create an audit trail for a patient. By automating this grunt work and providing accurate upfront information, Patient Estimates can make your collections process easy and efficient — not two words you typically associate with collections.

“The tool is really behind a lot of our success with billing and quick client payments,” says the Baylor University College of Medicine’s director of patient access. “Partnering with Experian Health has allowed us to be an advocate for our patients while also protecting our bottom line.”

Patient Estimates isn’t just a useful resource for patients; it’s also an efficient tool providers can use to avoid age-old payment problems. After all, your organization runs on payments, and you’d hate to miss out on essential revenue because you didn’t give your patients accurate information in the first place.

Bundle up

Combining Patient Estimates with other Experian Health services can extend the benefits across a wider range of services. Patient Estimates connects with Eligibility, for example, to generate up-to-date benefits information that can inform a patient’s treatment plan. It also works in lockstep with our Contract Manager solution to price estimates based on a provider’s payer contract, no matter how complicated it is.

The College of Medicine at Baylor University is among the providers that use Contract Manager to analyze contracts throughout clinical practice departments. After adopting Experian Health’s product suite, the school overhauled its internal collections strategy and generated more than 18,000 patient estimates while collecting $4.2 million in contractual underpayments it would have previously missed. Baylor has used its package of Experian Health products not only to streamline its workflow, but also to improve its patient collections rate and negotiate stronger contracts.

You don’t have to draw a hard line between helping your patients and making a profit. In fact, the two go hand in hand when you take the right steps. With Patient Estimates, everybody can get on the same page. Contact our team today to find out how to boost transparency in your organization.

To learn more about Baylor University College of Medicine’s experience with price transparency, please download this case study.

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No matter how much the healthcare industry evolves — whether through new legislative priorities or advances in AI and automation — one thing remains constant: the patient experience matters. Patients expect quality care, quickly. For five years running, timely access has been a top priority for patients, according to Experian Health's State of Patient Access surveys. But efficiency is just the start. In an uncertain world, patients also need reassurance, reliability and compassion. For revenue cycle leaders, meeting these expectations isn't just about good service. It's a competitive advantage. A patient experience built on empathy, convenience and personalization fosters loyalty and trust, driving both satisfaction and financial performance. With the right digital tools, providers can take meaningful steps toward improving the patient experience. What is patient experience and why does it matter? The patient experience encompasses every step the patient takes while seeking and receiving medical care. It goes beyond the clinical aspects of care and includes all the systems and strategies that determine a patient's access to care. From the moment they book their appointment through their clinical care and final bill payments, each interaction is an opportunity to make or break a patient's satisfaction with their provider. The patient experience can be a major driver of health outcomes. Inefficient systems lead to missed appointments, while confusing billing practices cause patients to postpone care. Adherence to care plans is more likely when patients are engaged and informed. And when patients feel positive about their healthcare experience, there are trickle-down effects for staff, who have more time to focus on priority tasks. It's also vitally important for an organization's financial outcomes. A positive patient experience increases patient retention, reduces billing disputes and accelerates payments. Research shows this goes both ways: well-implemented revenue cycle management improves the patient experience, too. What does a quality patient experience look like? Alex Harwitz, VP of Product, Digital Front Door, at Experian Health, says that a high-quality patient experience should encompass three things: “Choice, flexibility and convenience are themes that have come through strongly in our patient surveys. Patients are more mobile and more digitally active, so they expect services to be available on demand. They have a diverse range of schedules, responsibilities and preferences, and providers need to accommodate these variations so accessing care feels easy and convenient. Providers that leverage digital technology to deliver a patient-centered experience will see higher levels of patient engagement, better health outcomes, and a healthier bottom line.” Key strategies for improving the patient experience For healthcare providers, there's always a new delivery challenge around the corner. But it's also getting easier to improve the patient experience, thanks to digital technology. Here are five practical ways to make an immediate difference: 1. Reduce wait times Long wait times frustrate patients and lead to last-minute cancellations, which hurt revenue. Online self-scheduling, pre-visit digital check-ins and automated appointment reminders help keep schedules on track and reduce no-shows. According to the State of Patient Access 2024, these tools are also a smart way to meet patient expectations: 89% of patients want the ability to schedule appointments anytime, via online or mobile tools. 2. Streamline administrative processes with technology Manual data entry slows everything down. Patients dislike repetitive paperwork, while human error is a frustratingly common cause of denied claims, especially when that paperwork starts to pile up. Digital tools eliminate much of the hassle and allow staff to work more efficiently. Automated patient intake accelerates the admin tasks, so patients get the care they need without delay, and providers can keep revenue flowing without unnecessary roadblocks. 3. Improve communication between patients and providers Confusing communications are a major pain point for patients, and billing is a prime example. With 43% of patients saying they may postpone or cancel care if they don't get an accurate cost estimate, providers have an opportunity to stand out from the competition by offering clear and compassionate financial communications. Upfront estimates, proactive financial counseling, and digital payment options ease patients' anxiety, prevent disputes, build trust and increase collections. 4. Increase healthcare access with automation and AI Insurance hurdles are another source of frustration for patients. Uncertainty over coverage, eligibility and out-of-pocket costs can impede access, lead to billing disputes and increase the risk of claim denials. Manual verification is time-consuming for staff and often leaves patients waiting for answers. Automation and AI can eliminate these bottlenecks. For example, Patient Access Curator uses machine learning to verify and update all patient information with a single click. Watch the webinar: Revenue cycle leaders from Exact Sciences and Trinity Health share how they use Patient Access Curator to redefine patient access 5. 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UCHealth helped more patients qualify for financial assistance using Patient Financial Clearance, which automates presumptive charity screening. The tool disbursed $26 million in charity care and covered more than 1,700 patients. On-demand webinar: Learn how Community Health System used Experian Data to drive financial assistance automation. Prioritizing patient-centered healthcare The way the patient experience is delivered may change, but its role as a driver of trust, loyalty and financial stability does not. As patients become more mobile and digitally active, they expect care that fits into their busy lives — available on demand and tailored to their needs. By using digital technology to offer choice, flexibility, and convenience, providers can make care easier to access, strengthen relationships and improve both health outcomes and financial performance.  Find out more about how Experian Health's digital solutions help healthcare organizations improve the patient experience. 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