Topics that matters most for revenue cycle management, data and analytics, patient experience and identity management.
The Vancouver Clinic was facing the same problems that all healthcare organizations grapple with: too many claims denials and too much bad debt. So, Paul Brown, the clinic's chief financial officer, turned to his background in manufacturing technology to see how his organization could find efficiencies. He used his experience and knowledge to inform his and the clinic's roadmap to implement change. The first step was looking at quality. In manufacturing, every step in the process is studied closely and tested to ensure absolute accuracy. Vancouver Clinic did the same. From a patient perspective, it wanted a seamless experience, including making appointments, reducing patient time at reception, ensuring labs were returned quickly, and making sure patients had quick access to any prescriptions they needed. Although the improvements Vancouver Clinic wanted to make originally were seen as a technology project, it quickly became evident that improving the process would also require training for staff and defining performance indicators. However, as technology played a key role, Paul reached out to Experian Health to implement some much-needed automation in the revenue cycle process. One big goal for the partnership was to improve revenue and collections, which is important as U.S. healthcare spending continues to skyrocket. Spending has reached $3.5 trillion, and Medicare bad debt adds up to more than $3.69 billion. Experts predict these numbers will continue to grow, and soon, the nation will spend close to 20 percent of the gross domestic product on healthcare alone. Vancouver Clinic was also grappling with these issues. It had higher-than-average claims denial rates, which cost the clinic $10.5 million each year. It also had higher-than-average bad debt of $3.5 million. The goal was to reduce that by 50 percent, and the numbers are going in the right direction. To get there, Vancouver Clinic took a multifaceted approach to implementing software solutions. One solution was Payer Alerts, which creates authorization updates that reduce errors and inconsistencies before claims are submitted. When they’re detected, the alert format is easy to read and understand so corrections can be made quickly. Other technology solutions included Eligibility, which simplifies the insurance verification process; Payment Safe®, which is an efficient and seamless way to process patient payments; and Claim Scrubber, which helps submit clean claims to payers and reduce claim denials. The results for Vancouver Clinic were quick and dramatic. Claims denial rates dropped more than 30 percent. The denial rate, which was around 14 percent, is now under nine percent. Vancouver Clinic also reduced bad debt through more efficient patient processing by ensuring the clinic has the right insurance and personal information on patients. By collaborating with Experian Health, Vancouver Clinic has turned things around and has already realized a reduction in claim denials and bad debts to save them $2.3 million. An additional benefit of implementing these software changes is the ability for patients to use the self-service portal for the clinic. It allows patients to get estimates for services, set up payment schedules, pay their bills, schedule appointments, and provide feedback to the health system. Giving patients the ability to take control of these tasks simplifies the process for everyone, reduces busywork for staff, and improves patient satisfaction. Another efficiency that was implemented for staff was revamping software work lists. By reducing the number of lists they had to manage, employees were able to streamline their work. In an effort to maintain and continue to improve efficiencies, several key performance indicators are monitored to ensure quality throughout every step of the process. In much the same way that manufacturing keeps an eye on each process along the way, Vancouver Clinic has sought to improve every detail to create a seamless experience for patients. Through its continued partnership with Experian Health, it is well on its way to getting there.
This time last year, the Centers for Disease Control and Prevention and hospitals across the country weren’t quite ready for the flu season, which turned out to be the deadliest in 40 years. The flu and complications arising from it resulted in the deaths of more than 80,000 people. Hospitals felt the brunt of the 2017-2018 epidemic early. Hospital and medical center staffs were forced to work overtime, setting up triage tents and treating flu patients in recovery rooms. Alabama declared a state of emergency, and doctors in California had to treat patients in hallways. Experts predict a milder flu season this year, partly due to an updated flu vaccine that protects against H3N2, which was the severe strain that dominated last year’s flu season. While it's hopeful that this year’s flu season will be better, it's always a busy time for hospitals and providers, so they should be sure they're using the most efficient healthcare IT solutions to streamline their workflow. Greater efficiency is key When it comes to efficiency, hospitals should take a cue from Martin Luther King Jr. Community Hospital in Los Angeles, which collaborated with Experian Health to streamline patient registration and insurance verification. Before the collaboration, MLKCH had to consult websites and make phone calls to confirm a patient's insurance eligibility, which was time-consuming. The hospital has a large Medicaid and managed care population, which means employees had to consult both a state website and a health plan website. The hospital also had a high-traffic emergency department and limited front-line staff to handle the incoming flow of patients. Additionally, employees performed manual quality assurance, which is a time-consuming task. Understanding its challenges, Experian Health was able to help the hospital streamline its system to improve efficiency in insurance verification through Coverage Discovery. It also helped the hospital improve patient registration with Registration QA, which has improved data quality and patient registration accuracy. Since MLKCH integrated Coverage Discovery and Registration QA into Cerner, it has saved precious time when it comes to validating patient and payment information. “We have a lot of returning patients to our emergency room, so once we check that patient in, their eligibility automatically runs in the background and our staff doesn’t have to go into another website to check their eligibility," said Lori Westman, patient access manager at MLKCH. “This has saved us two to three minutes of our registration time.” “We average about 300 patients every 24 hours,” she continued. “Heading into flu season, they're expecting to hit a 400-per-day volume, so the fact that we can take off two to three minutes at least on half of our registrations is going to speed up the work for the team that much faster, to have a turnaround time that much better for more patients to come through.” Managing the season Only 42 percent of Americans got a flu vaccine last year — painfully shy of the CDC’s 70 percent target. Misconceptions and fears about the vaccination and its effectiveness can keep people from getting it, which only increases the spread of the flu. Flu season is always going to be a busy time for healthcare providers. But finding ways to manage staff and resources and work more efficiently is going to help hospitals and other facilities better manage the busy season. Learn more about Experian Health’s Patient Access solutions.
In healthcare, patient-facing technology and electronic health records are meant to improve the overall patient experience. Yet, in a recent Black Book survey, the limited use of these technologies by some organizations has diminished the experience for 89 percent of their younger patients. More specifically, 69 percent of respondents said that dissatisfaction was due mainly to the discharge and billing process. A lack of transparency, confusion about what the total costs are, and borderline harassment from third-party collections agencies can ruin otherwise great experiences. What’s lacking? To achieve the level of engagement and transparency that consumers demand, hospitals need to offer more than just electronic records. In Black Book’s survey, 78 percent of hospitals aren't prioritizing investing in the IT necessary to offer more. That number is shrinking, though, as hospitals depend more on payments from patients. A brief prepared by the Office of the National Coordinator for Health Information Technology showed a 10 percent jump in the use of IT, such as patient portals, between 2014 and 2017. However, 24 percent of patients won’t view their EHRs despite being offered access. Many cite privacy concerns, others see no need, and some just don’t know how. While confusing and unclear billing processes can negatively impact the patient experience, the opposite is also true. When organizations make it easy for patients to understand and pay their bills, their patients are more satisfied with their experiences. That requires revamping both billing and customer service — the two most important avenues of engagement. 3 areas to improve To achieve that goal, more healthcare organizations and hospitals are turning to online patient portals. They not only give patients access to their records, but also consolidate doctors’ and hospitals’ bills into single, easy-to-understand statements. This increases a patient’s ability and willingness to engage, as well as reduces a hospital’s risk of uncompensated care. Still, patient portals don’t automatically translate to better engagement. They offer a wide range of features and interactions, but they can do little to positively impact the patient experience until organizations become more adept at optimizing them. In many cases, that means changing their approach to these three main obstacles: 1. Limited use A recent Healthcare Financial Management Association survey revealed that 94 percent of organizations that use patient portals only use them to collect payments from patients. This is an important feature of a portal, but it’s only one of several equally important ones designed to create an entire experience for patients. Most portals offer the ability to schedule appointments, receive accurate patient estimates, research and select different payment plans, communicate with care team members, and more. Organizations can use them not only to collect payments, but also to help patients be active participants in the administrative side of their care. 2. Limited interoperability For a healthcare organization to make full use of patient portals and other health IT solutions, large amounts of data must be gathered from many different sources. For a single patient, that data can include financial information from credit bureaus, health histories from other institutions, and data from personal medical devices. Limited interoperability makes it difficult for providers to centralize disparate sources of data, which hinders their patients’ ability to make full use of a portal’s features. By creating a portal around a more comprehensive IT infrastructure, organizations can improve their interoperability and, therefore, their patients’ overall experience. 3. A lack of self-service In the HFMA survey mentioned above, 86 percent of organizations that responded admitted that a portal’s most valuable contribution is creating an intuitive, self-service environment for patients. The ability to schedule appointments and payment plans means organizations don’t have to cold-call patients to remind them of upcoming visits or past-due bills. When hospitals make full use of a patient portal’s features, they can help patients manage their own accounts from home, work, or the doctor’s office. This level of self-service empowers patients to engage in their healthcare, reducing the likelihood of missed appointments, uncompensated care, inadequate patient experiences, and poor health outcomes. The fact that more healthcare organizations are offering patient portal access is encouraging, but low patient interaction means they could do more to optimize that access for maximum engagement. Fortunately, the pieces are there; organizations just have to learn to adapt the rest of their operations to make it all fit together. Start engaging with patients today.
Healthcare consumerism, which describes the ability of patients to shop around for the best value of care, has affected every aspect of the industry. Keeping up with those changes has challenged most institutions as patients become more savvy about healthcare costs and their choices. But the freedom for patients to choose is only one side of the coin. The other is wrought with financial pain points that come with making the traditional billing model fit the new healthcare consumerism. For instance, organizations have to give patients precise cost estimates, but when patients change insurance coverage or companies change their policies and practices, providers struggle to keep those estimates accurate. And patients who are hit with unexpected costs after they’ve received treatment are less likely to be able pay their bills. Hospitals and providers suffer from uncollected bills, which is compounded by claims denials. Fortunately, the idea of healthcare consumerism inherently provides the solution to the pain. Emulating consumerism that's present in other industries, such as retail, means offering accurate and transparent pricing, eliminating uncertainty, and offering patients convenient and comprehensive financial options. Like other industries, healthcare already has a wealth of IT tools to make that possible. Headaches for patients and providers Simplifying financial pain points requires one significant change — hospitals and providers must deliver clear, simple information about what factors into their pricing. The first step is ensuring your system can keep up with the constantly changing details of insurance policies, supplier contracts, and everything else that affects those costs. An automated IT solution can collect up-to-date insurance data, claims history, a patient’s financial situation, your organization’s price, and more before generating an estimate. When this data changes, estimates are no longer accurate, which is why healthcare pricing is so complicated. Therefore, tracking them and updating your system automatically can make it easier. Most of the industry already uses analytics to some degree. Combined with automated financial data-gathering tools, those analytics can help organizations identify patients who are financially at risk and might qualify for additional funding options. Along with clear and accurate estimates, patients highly value a provider that cares enough to offer affordable financing options. Alleviating those pain points Keeping up with policy and other financial changes as quickly as they occur makes healthcare consumerism as beneficial for hospitals and providers as it is for patients. For example, Rocky Mountain Cancer Centers was able to reduce claims denials by 27 percent after implementing payer alerts and patient estimate solutions. The same strategy helped the College of Medicine at Baylor University collect nearly $4.2 million in underpaid contracts, which it would have missed otherwise. Both organizations have also significantly boosted patient satisfaction with their financial processes, which has led to more positive experiences and reviews. You can also alleviate financial pain points for patients and your organization by seeing healthcare consumerism as an opportunity instead of a burden. Patients demand the same level of cost transparency and certainty from every other industry. Healthcare organizations now have the incentive (and the means) to prove that they can offer the same level of service.
In a recent healthcare information technology survey, more than 40 percent of chief information officers identified patient matching as healthcare’s top IT concern. And though a quarter of the respondents admitted it wasn’t a current priority for their organizations, they did say that it very much should be. There’s no shortage of reasons why, but the most pressing is the need to reduce medical errors, which account for over 250,000 deaths in the United States every single year. Case in point: Seventeen percent of CIOs acknowledged that errors in matching data with the right medical identities have led directly to adverse outcomes for patients. The numbers speak for themselves: Healthcare organizations must find more effective ways to manage the data within their networks. That begins with building a robust medical database that not only hoses data, but also knows how to match it with the proper patients. How robust EMPIs streamline workflows An enterprise master patient index (EMPI) is a database that can help you clean up your data and eliminate duplicate and inaccurate records. It uses algorithms to match exact data elements among disparate records, as well as elements that fall within an acceptable range of possible compatibility. Using technology that can apply an algorithm of probabilistic and referential matching methodologies will allow healthcare organizations to expand beyond the limitations of conventional single methodology matching, as both probabilistic and referential matching techniques provide a higher degree of likeliness. The system assigns these data points to unique identities that follow patients throughout the organization. Any new data generated within the network is also attached to this identity, meaning physicians, specialists, pharmacists, and other members of the patient’s care team can access and update it as needed. EMPI support tools and unique patient identities are building blocks toward creating a healthcare ecosystem that’s truly interoperable. According to an April 2018 survey by Black Book, hospitals with an EMPI report “consistently correct patient identification at an overall average 93 percent of registrations and 85 percent of externally shared records among non-networked providers.” Unfortunately, not all healthcare systems possess the IT infrastructure to support these programs. And as long as some organizations fail to integrate similar platforms, providers won’t reap the benefits of industry-wide interoperability — and patients will continue to suffer. Whether it’s a frustrating billing mix-up, privacy breach, or a detrimental (or even fatal) misdiagnosis, many errors can be successfully prevented with an EMPI. Filling in the holes The goal of such a system should be to standardize data entry and access within each healthcare organization, as well as across the entire industry. Such a network could protect, govern, and match unique patient identities across every discipline and every aspect of their care continuum. But in order for the system to achieve these goals, you need to be sure you’re feeding it relevant, recent patient information. To ensure you have enough patient data to build an EMPI that accurately matches profiles, ask yourself these questions: 1. What kind of medical care have my patients received before this visit? When patients enter a new hospital, they’re given a brand-new identity, or patient number, that’s only relevant to that healthcare system. The identity you assign them within your own organization doesn’t provide any insight about what they’ve experienced before their current visit — and that’s the crux of the matter. When patient information is siloed within a specific system, you have no view of the patient’s medical history. But when it’s shared across systems and fed into a more dynamic and interoperable data management system, patients will ultimately receive better care. 2. Who are my patients when they’re not “patients”? It’s important to understand who patients are when they’re not in the hospital. Yes, they’re husbands and wives, mothers and fathers, brothers and sisters. But some could be physically fit, while others haven’t seen the inside of a gym in years. Some might get regular checkups, but others cannot afford to see a physician regularly. All of these traits factor into your patients’ identities. With a comprehensive EMPI, you can tie them together to understand the environmental and socioeconomic factors that influence your patients’ health. You can then identify what social determinants of health need to be addressed or could potentially influence the efficacy of certain treatments. 3. Can we identify patients without a picture ID? Biometrics such as fingerprints and iris scans are more secure forms of identification than a photo ID. They’ll not only make it easier to identify patients, but will also offer heightened security against fraud. That being said, even biometric identification isn’t 100 percent secure unless it’s part of a database, such as the EMPI, that accurately matches patient identities with relevant medical data. Accepting that the healthcare industry needs better data management and patient-matching strategies is the first step to realizing those goals. EMPIs have shown organizations the value in universal patient identities. Now, they simply need comprehensive databases that are robust enough to keep patient identities consistent across the entire healthcare ecosystem.
Not every healthcare organization embraced electronic medical records (EMRs) at first. But the incentives and regulations put in place by Meaningful Use and the Affordable Care Act have made it necessary to implement them. Now, organizations are not only embracing EMRs, but also making it easier for their patients to access and manage them through remote portals. According to the Office of the National Coordinator for Health IT, approximately 63 percent of patients who used portals did so at their doctors’ recommendation. Despite the growing popularity of patient portals, there are still more than 25 percent of patients who refuse to use them for fear of jeopardizing their data. Considering the sensitive nature of their protected health information (PHI), along with the nearly 5.6 million health records that were compromised last year, those fears are more than reasonable. What can providers do? Hackers have honed in on the healthcare industry for two main reasons: the treasure trove of valuable information in medical records and a sometimes dated approach to cybersecurity. In fact, between 2009 and 2016, more than 30 percent of all big data breaches occurred within healthcare systems. Without proper encryption methods, login redundancies, and detection tools, portals are almost as easily accessible to hackers as they are to authorized users. As their usage grows, that lack of security will become an exponentially greater threat to patients’ PHI and identities. “Many of us are accustomed to keeping the same name and password with our accounts, and as we know, that information is very lucrative to the right individuals," says Victoria Dames, Director of Identity Management for Experian Health. "While it's our due diligence to constantly change them, there are certain scenarios where maybe we forgot to change them or we don’t regularly login and that password may sit idle. When that happens, you want to make sure that you have the right technology in place to be able to catch somebody potentially logging in, trying to impersonate a patient.” Providers can’t lower the value of PHI to make it less attractive to hackers, but they can protect it more effectively with up-to-date cybersecurity measures. These four tips can help organizations bring their patient portal security up-to-date and keep their networks safe from unauthorized access: 1. Automate the portal sign-up process. Automating the initial sign-up process can stop false enrollments into the portal at the source. When implemented correctly, the automation will only require the patient to enter a few pieces of information, and then the software can confirm the user’s identity on the back end. 2. Leverage multilayer verification. After patients have signed up to access the portal, using multilayer verification can ensure all future sessions are equally secure. For example, two-factor authentication adds additional protection on top of conventional login credentials. In addition to a password or PIN, users also have to provide something personal such as a cell phone number, ZIP code, fingerprint, iris scan, or more. If the user’s device, account ID, and/or password are compromised, two-factor authentication can ensure the organization’s network remains safe. 3. Keep anti-virus and malware software up-to-date. Multilayer verification protects users’ direct access to portals, but there are other, more frequent vulnerabilities that also need attention. For instance, HIMSS Analytics recently found that 78 percent of providers experienced ransomware and malware attacks last year. Email is the avenue of choice for malware, and these attacks constantly evolve to slip past conventional security measures. If anti-virus software is outdated, it remains vulnerable to every new iteration of malware that attacks the network. Most solutions allow for automatic opt-ins so updates are downloaded and installed as soon as they’re made available. 4. Promote interoperability standards. When primary care physicians, specialists, and healthcare payers talk to one another throughout the course of a patient’s care, it isn’t always through email. When their systems aren’t compatible, they can’t communicate as clearly and securely as they need to. Interoperability makes it possible for disparate systems to share medical histories and patient data while making that data easily understandable on either system. Because interoperability is essential for improving the continuum of care, the Centers for Medicare and Medicaid Services provide standards for healthcare organizations to promote it. More patients and providers are optimistic about using technology to improve the healthcare experience. However, one in five patients remain so suspicious of healthcare data security that they refuse to even divulge some information to their physicians. Fortunately, with the right tools, organizations can effectively strengthen portal security and boost the confidence their patients have in them.
This week, Experian Health is a proud partner of National Health IT Week. U.S. National Health IT Week is a nationwide awareness week focused on catalyzing actionable change within the U.S. health system through the application of information and technology. Comprehensive healthcare reform is not possible without system-wide adoption of health information technology, which improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers. Initiated in 2006 by the Healthcare Information and Management Systems Society (HIMSS), National Health IT Week has emerged as a landmark occasion for using health IT as part of the overall solution to improve America’s healthcare as a bipartisan, federally led, market driven initiative. While the healthcare industry has transformed in the last decade as health organizations have moved to electronic health records (EHRs), it brings us one step closer to the vision of comprehensive care coordination, but fully achieving care coordination across the vast health enterprise is still a long way ahead. While a recent American Hospital Association (AHA) survey showed that nearly all reported hospitals (96 percent) possessed certified EHR technology in 2015, the Office of the National Coordinator for Health Information Technology reports that there is very little coordination of patient data across the healthcare ecosystem. Much of this disconnect begins with the inability to transfer data in a secure manner that will match, manage and protect patient identities across enterprises. "As hospitals must now deal with hundreds of thousands of electronic patient records, spanning multiple systems and departments, the traditional technologies to managing patient information are no longer sufficient," says Karly Rowe, Vice President of New Product Development, Identity and Care Management Products for Experian Health. "Leveraging sophisticated matching technology and outside data sources, can improve patient identification and prevent duplicate or overlapping records which result in inappropriate care, redundant tests, and medical errors – as well as make data accuracy higher for clinical, administrative, and quality improvement decision purposes." To solve the industry problem of matching, matching and protecting patient identities across the healthcare ecosystem, we must start by creating a universal patient identifier (UPI) to make patient data truly interoperable. For example, one of the biggest challenges in managing patient data begins when patients move, change names, or switch doctors and their EHR doesn’t follow them. They have to start over, trying to recall events and dates in their medical history with a new doctor, who is tasked with providing care without the detailed insight into the patient’s medical record. But if that same patient had a universal identifier that allowed healthcare providers to communicate with another healthcare provider about a patient, the new provider would know all the ins and outs of that patient’s history, leading to a more holistic approach to care and higher patient satisfaction. Simply put, a UPI can be thought of as a mechanism to link all patient information and associate it with the right individual based on patient data. This is similar to how credit bureaus link an individual’s credit history to the right individual to ensure accurate reporting. Using a similar model, patient data — and supporting patient demographic data — can be used for the common good to improve patient safety, increase quality of care and reduce mistaken identity risks. The benefits of a UPI extend across the entire healthcare system as well, as it improves the quality of patient identities, which can have duplicate, overlapping and incomplete records. Additionally, a UPI can help eliminate incorrect medical treatments; deliver current and accurate patient data; and prevent identity fraud, HIPAA breaches and incidental disclosures of protected health information (PHI). Ultimately, this will build patient trust through increased visibility and record accuracy. Knowing that preventable medical errors, many of which are the result of incorrect patient identification, are the third leading cause of death in the United States. The creation of a UPI will allow the healthcare industry to facilitate accurate information exchange to stop problems before they start. For example, if a patient shows up to fill a prescription and is mistaken for another patient with the same name and given the wrong prescription, there could be fatal interactions with other medications that patient is taking. The National Council for Prescription Drug Programs (NCPDP) has already started using this technology to establish national patient safety identifiers. A national patient safety identifier, or UPI, is a vendor-neutral, cost-effective solution that will link patient data at scale efficiently and accurately to improve patient safety and care coordination. Identity management is a critical, underlying component to every interaction, and healthcare is no exception. To fully achieve the goal of comprehensive care coordination, creating a UPI to help match, manage and protect patient data is the first step in achieving the interoperability of patient data. Participate in National Health IT Week’s Virtual March and help catalyze actionable change within the U.S. health system through the effective use of health IT.
Healthcare providers are always balancing a million tasks at once. The most important of these tasks, obviously, is serving patients, which can sometimes crowd out the important but thankless business functions — like keeping tabs on the insurers you're processing. Payers are changing their policies and practices constantly, and those changes are easy to miss when you're focused on everything else you have to do to keep a healthcare organization running. But if a payer policy changes without you knowing, it’s going to cost you. If your denial rate ticks up because of an unknown change in payer policy, you could end up spending thousands of dollars per year to rework those extra claims. The good news, though, is that there’s a tool that can lighten the load. Experian Health’s Payer Alerts service keeps you in the loop about the payer policies and procedure changes you’re too busy to catch. That way, instead of poring over the mergers, acquisitions, and countless other details that affect the insurance industry, you can stay focused on what’s really important — without making sacrifices to your bottom line. How it works With Payer Alerts, every notification you receive is the result of extensive behind-the-scenes work by our software. The program monitors more than 50,000 web pages that payers visit and records any relevant policy changes before preparing an alert for you. The alert contains a detailed summary of those changes and a link to the affected policy. Once you receive the alert, you can just follow the link and make the necessary adjustments to your internal procedures. But given the variety of potential policy changes, those adjustments can be tough to pin down. That’s why every alert categorizes each change by healthcare specialty, allowing you to receive the alerts most related to your organization. And the customization goes further than that.Want an email that describes all relevant administrative changes? Done. Want a web-based portal where you can identify any reimbursement issues? Easy. Regardless of what you need, the alert will be waiting for you in the right platform. Finding ROI in new information Being privy to policy changes without having to sift through insurance jargon can mean a lot for a healthcare organization. “When things change and information is always current, that’s a huge benefit,” says the director of managed care at Rocky Mountain Cancer Centers, a longtime user of Experian Health’s services. When you’re in the loop about what’s covered and what's not, you’ll also be in better shape to increase your revenue and cash flow. RMCC, for instance, reduced its denial rate to 27 percent in its first year using the service and has reached a $1 million ROI on the investment year over year. Payer Alerts isn’t some app that bombards you with pointless notifications every five seconds. By giving you the necessary information to make timely, strategic decisions, the software can help you start running your practice more like a lucrative business. Building the perfect defense Payer Alerts helps healthcare organizations streamline their workflow and maximize revenue through more than just its immediate features; its compatibility with other Experian Health services can provide the perfect defense against the myriad payer issues that might arise. Combining Payer Alerts with our Contract Manager and Contract Analysis solutions not only keeps you up-to-date with policy and procedure changes, but it also helps you target those changes in ways that meet your unique needs. When RMCC realized that sending out individual forms for different information was wasting time, it used its Experian Health software package to aggregate all the data from those separate appeals into a single form. This helped the company reach its efficiency improvement objectives, satisfying both patients and staff. Ultimately, you can’t fix any issues with your insurance processing if you don’t know they exist, and you won’t even know there’s an issue if you aren’t aware of the constant policy changes in the industry. While you can’t stop these changes from occurring, you can invest in a system to adapt to them and avoid the agony of having to scrutinize it all yourself. If you're ready to learn more about Experian Health's Payer Alerts, get in touch with us today. To learn more about how RMCC used Payer Alerts to increase revenue and cash flow, download the case study.
Last year, the National Academy of Medicine estimated that excessive and unnecessary medical tests waste at least $200 billion a year in the United States. The same report estimated that, in addition to the monetary costs, the mistakes resulting from unnecessary tests and treatments can lead to 30,000 deaths annually. No healthcare organization wants to write wasteful and unnecessary medical orders — they're bad for patients and for business. Unfortunately, given the fact that so many providers might be submitting and fulfilling orders for one patient, finding a way to organize a patient's treatment schedule in the most effective and efficient way can be difficult. For many healthcare organizations, however, Experian Health can provide a solution: Order Manager, a web-based platform for tracking treatment orders. Order Manager in action Experian Health’s Order Manager is a component of its comprehensive eCare NEXT® suite of healthcare workflow solutions. Order Manager facilitates communication between every player in a patient’s course of care — hospitals and health systems, standalone clinics, community physicians, and even testing facilities can all verify or update a patient’s testing and treatment schedules when necessary. Order Manager integrates data into a patient's electronic medical record so all supplementing data or documents he or she accumulates are captured and organized within a centralized interface that has actionable suggestions. The all-in-one platform gives providers a GPS-like ability to track an order until it's completed, and every provider in the patient’s circle of care can see what tests have been ordered, what medications have been prescribed, and what the results have been. With Order Manager, staffers don’t have to manually place orders or call the patient’s original hospital or doctor to verify prior authorizations — no more duplication, no more conflicting and dangerous treatment plans, and no more confusion. When ordering systems aren't automated, it doesn’t just affect patient care; the labs that fulfill the orders are getting squeezed by inefficiencies, too. For Aegis Sciences Corporation, a leader in healthcare and forensic laboratory sciences, Experian Health’s Order Manager helped optimize order processes as efficiently as it has for hospitals. Aegis Sciences wanted to provide staff members with the tools they need to consistently provide a positive experience to patients and the physicians they work with, and Order Manager has been an important tool in helping the company do so. The web-based platform improved efficiency and reduced costs by transforming operations into fully paperless processes. Healthcare staff at Aegis Sciences said Order Manager was key in supporting the quality of the organization’s work, particularly the processes that require certain authorizations to be completed before tests can be ordered. With the help of Order Manger, Aegis Sciences was able to reduce the time spent on tasks such as accessioning — the arduous process of logging and sorting a sample in a larger data collection — to less than a minute. In fact, according to Aegis Sciences: "Experian Health's Order Manager teams were key in helping us realize our vision of a fully paperless process that could improve our workflows and processes to keep pace with our exceptional growth. We're now able to offer a fully paperless process to our clients and require that certain fields, such as demographics and diagnosis codes, be completed on the front end." Client satisfaction at Aegis Sciences has risen thanks to a 27 percent reduction in errors and necessary follow-ups, as well as a 76 percent drop in attestation statements during the verification process. To learn how Experian Health's Order Manager can help your organization improve the quality of care for your patients and consumers, feel free to contact us today. Our team can assess the role that Order Manager could play in your organization's workflow and help you implement it in the most efficient way. To read more about Ageis Sciences' experience, download this case study.