Collections Optimization

On April 1, 2023, millions of Medicaid recipients are set to lose coverage as the U.S. government’s COVID-19 public health emergency (PHE) expires. The Kaiser Family Foundation estimates that 5.3 to 14.2 million people will lose Medicaid coverage as the continuous enrollment provision of the PHE ends. Of this group, 6.8 million may be eligible to re-apply for Medicaid, but in the immediate term, it falls to patients and providers to sort through coverage questions, navigate charity and Medicaid eligibility, and keep bills out of collections. Mindy Pankoke, Senior Product Manager at Experian Health, shares her insights on how Patient Financial Clearance and other digital solutions can help providers and patients cut through the confusion to achieve the best healthcare and financial outcomes during this time. Q1: The public health emergency is ending on April 1, which means that many will lose Medicaid coverage. How will this impact providers and patients? “Patients who qualified for Medicaid under the Public Health Emergency requirements during COVID will be dropped from Medicaid on April 1, leaving them without coverage,” explains Pankoke. “Healthcare organizations have been trying to reach out proactively to pre-enroll some of these patients, but others may not know what their options are or may show up to receive care without realizing they no longer have coverage.” Patients will face a range of financial challenges. “Self-pay patients may defer treatment, which could keep them from receiving the care they need and may ultimately lead to more costly hospital visits,” Pankoke says. “Also, patients may be confused about what’s happened to their coverage and what their options might be going forward. If they end up being responsible for paying out of pocket for care, some may have to choose between paying their medical bills and paying for food or utilities.” Providers will see a surge in patients needing help after losing Medicaid coverage With millions of patients in flux, providers will need to dedicate time and attention to helping patients sort through their concerns, including: Confirming whether Medicaid coverage is still in force Verifying coverage with new insurance Determining eligibility to re-enroll in Medicaid Qualifying patients for full or partial charity care Explaining patient financial responsibility and working out payment plans Managing billing and collections with a higher volume of accounts in AR Optimizing outcomes so that patients get the best care possible and providers end up with the least amount of bad debt Time is a critical element. Lengthy processes and administrative delays are likely to increase patient stress levels. Meanwhile, many providers face industry-wide staffing shortages. Time-consuming manual processes, multiplied by a sudden surge of affected patients, could quickly become overwhelming for staff. “For providers, this could be a hard situation to navigate,” says Pankoke. “At the same time, it gives providers an opportunity to come through for patients in a moment of need. Being able to identify patients who need assistance and offering them help can be powerful.” Q2: That raises an important question: How can providers create a compassionate experience for patients? “I think awareness is one place to start: making sure your staff knows this change is coming and that they understand the impact,” Pankoke says. “Your staff are the ones who’ll be working with patients personally when they come in and find out they no longer have Medicaid coverage.” But compassion doesn’t end there. “Many providers already have charity programs in place to provide relief for patients who can’t afford care,” says Pankoke. “The challenge lies in identifying the patients who need that charity assistance and connecting them to the help that’s available, while also learning which patients may still qualify for Medicaid and need help to re-enroll. Patient Financial Clearance uses credit and non-credit data to identify patients who may still be eligible for Medicaid, as well as self-pay patients who may qualify for charity assistance.” Using data-driven digital tools to quickly and proactively size up patient financial needs and offer personalized help can make the patient experience more humane. “Making these steps easier is another piece of being compassionate.” Q3: Screening for charity can be complicated, especially when new regulations are introduced – how do providers streamline this process? “My best advice is to embrace your charity programs and use a partner like Experian Health to help you automate the financial assistance screening process,” says Pankoke. “Patient Financial Clearance removes the manual screening for the likelihood to qualify for your charity programs and Medicaid.  It can automate the document-gathering in a patient-friendly way, and speed up the process to extend charity assistance, or work to enroll those likely to qualify for Medicaid early on before patients go through a costly uncollectable experience.” Automating these processes doesn’t have to be onerous. “Clients can provide their charity policy  requirements to Experian Health and let our expert consultants help to create the most effective and efficient workflows for Medicaid and charity screening both  up-front and as back-end scrubs.” Pankoke also urges providers to consider patient self-screening options as well: “Providers should consider other options aside from paper applications.  We’ve seen clients shrink the application process from 60 days of paperwork down to 3.5 days by enabling patient self-screening options via text.  This creates a better experience for the patient and hospital staff.” Q4: What else can providers do to help patients manage the cost of care? Providers can focus their resources on improving the patient's financial journey—for all patients, not just those who are struggling with their Medicaid status. Pankoke’s suggestions: Reach patients on their preferred channels - “Providers can empower patients with less paper-heavy ways to apply for financial assistance. Text and online applications embedded on your website or patient portal put the power into the patient’s hands using the channels they prefer.” Providers can also offer patients the ability to make payments right from their mobile devices using Patient Financial Advisor, making it easier to pay outstanding bills anytime and anywhere. Use data to gain insight into patient finances and offer personalized options - “In addition to screening for possible charity and Medicaid eligibility, Experian data enables providers to offer realistic payment plan options that consider how much the patient is likely to afford, enabling patients to bite off what they can chew with higher likelihoods of making payments successfully.” Customize collections - Sending patients who are struggling to collections may not be cost-effective or compassionate. “Providers don’t want to hound people for payment if the patient is having trouble covering their basic expenses and could qualify for Medicaid or charity care,” says Pankoke. Using Collections Optimization Manager, providers can tailor collections processes to their own specific needs. “A partner who is agnostic to your in-house and early-out agencies can help you manage, monitor, and optimize agency performance for maximum revenue.” Providers who are concerned about upcoming shifts to Medicaid coverage may want to consider leveraging solutions like Patient Financial Clearance, Collections Optimization Manager and Patient Financial Advisor to help them meet this challenge—along with the many challenges of managing patient financial needs in a rapidly-changing world.

Clear, convenient and compassionate – patient-friendly billing should check off all three. But how many patients see this in practice? For many, the healthcare billing and payment process can be intimidating, confusing and rooted in paper-based systems that are slow and prone to error. With the right technology, providers can improve the billing experience by making it easier for patients to understand their financial responsibility and plan their payments. Online patient payment software can streamline the billing process by giving patients more flexibility and control. Here are 5 patient-friendly billing practices that providers can implement to improve the patient experience and protect revenue: 1. Provide proactive and reliable cost estimates Patients don’t want to feel like they’re in the dark when it comes to figuring out their financial responsibility. Unfortunately, too many receive no upfront estimates of the cost of care or receive estimates that aren’t accurate. This financial uncertainty can have a knock-on effect on patient care and provider cash flow. A survey by Experian Health and PYMNTS found that 46% of patients had canceled care after receiving a high-cost estimate, while 60% of patients with out-of-pocket expenses said they would consider switching providers after receiving inaccurate estimates. Patient Payment Estimates generates accurate, personalized estimates for each patient before and at the point of service. The patient’s liability is clearly broken down so they know exactly what to expect. Patients feel more in control and can make quicker, better decisions about how and when to pay (including paying upfront if they wish). This tool also helps providers comply with the Hospital Price Transparency Rule. 2. Eliminate confusing billing information In the age of Amazon, patients expect billing information to be clear, accessible and provided through their preferred channel. Long paper statements sent by mail or a single phone number to call during limited office hours likely won’t cut it. Providers should consider a multichannel approach that uses relevant patient financial data and consumer preferences to deliver personalized options. PatientSimple® is a self-service payments portal that allows patients to view statements online, generate pricing plans and manage their bills, all from a single dashboard. Patients can get automated email reminders and even pay in full. When patients have all the information they need at their fingertips, providers can spend less time handling queries and chasing payments. 3. Find missing coverage early Another ingredient in patient-friendly billing is to help patients reduce their liability, by tracking down any insurance coverage that might have been forgotten. Many patients relocated or changed employers during the pandemic, leaving many unclear about their current coverage. They may be misclassified as self-pay or assumed to have only one form of insurance. Coverage Discovery automatically checks for any active coverage that may have been missed. In 2021, Coverage Discovery tracked down previously unknown billable insurance coverage in more than 27.5% of self-pay accounts, finding over $66 billion in corresponding charges. This greatly reduces the financial burden on patients, while increasing reimbursement rates for providers. It’s just one example of a non-patient-facing tool that works behind the scenes to streamline patient collections. Discover how Stanford Health Care collaborated with Experian Health to optimize collections and improve the patient experience with Coverage Discovery and Collections Optimization Manager.  4. Patient-friendly billing requires personalized payment plans When it comes to payment, some patients will prefer to pay upfront and in full, while others want or need to spread out the cost into more manageable chunks. Providers can pull together financial, demographic and consumer data to point patients toward the right pathway. This is how Patient Financial Clearance works: patients are guided to a payment plan that makes the most sense for their individual situation, with a clear breakdown of what they’ll need to pay and when. Patients are automatically screened for financial assistance programs and can fill out applications online. 5. Allow convenient and flexible ways to pay Patients want simple and easy ways to pay. They expect a choice of quick and convenient digital payment methods that can be accessed anytime, anywhere. The preference for digital payment solutions is especially apparent among younger generations. More than half of millennials say they’re “very” or “extremely” interested in digital services. With online patient payment software, patients have the option to pay multiple providers at once, using multiple forms of digital payments. They can store credit card information on file or set up a digital wallet, and set up automatic recurring payments to stay on track. Offering secure, flexible and instant payment methods to patients from the start of their healthcare journey increases the chance of prompt payment. Patients are free to focus on their health, while providers will see an increase in cash flow with less time spent on collections. Patient-friendly billing practices create better patient experiences  Outdated patient portals, poor communication and clunky billing processes do not make for a patient-friendly financial experience. The good news for providers (and their patients) is the growing menu of digital tools to offer patients the clarity and flexibility they expect. Experian Health President Tom Cox says: “Payment options are increasingly digital and more convenient, payment plans are more common, and price estimates have become less of a rarity. There is also greater use of non-clinical data to get a broader view of patients and their unique financial solutions. Data, coupled with the right technology, can help providers make sense of it all and enhance the patient journey.” Find out more about how Experian Health’s online patient payment software can help healthcare organizations build a modern financial experience to benefit patients and providers.

“With rising patient costs, there has been a need to increase engagement and keep costs low, while utilizing our resources wisely. Collections Optimization Manager is doing that for us, saving time and resources.” — Kristine Grajo, Director of the Self-Pay Management Office at Stanford Health Care Challenge Stanford Health Care is a level-1 trauma center operating between San Francisco and San Jose. In pursuit of its mission to heal humanity through science and compassion, it delivers clinical innovation across inpatient services, specialty health centers, physician offices, virtual care offerings and health plan programs. With more than two million outpatients going through its doors each year, Stanford Health Care is alert to the impact of growing patient financial responsibility. To increase collections and deliver an outstanding patient experience, the organization looked for ways to increase efficiency, reduce manual workloads, and reduce costs using data-driven insights and automation. They set out to: Use data-driven insights to remove uncollectible accounts Maximize patient collections by prioritizing patient collection inventory Identify missed coverage on true self-pay and Medicare accounts Decrease manual interventions and collections calls and improve efficiency Reduce the cost to collect, particularly around contingency fees with third-party collection agencies Solution Stanford Health implemented Collections Optimization Manager to maximize recovery and reduce costs. This tool scrubs accounts that shouldn’t be targeted for collections, so staff can focus their time in the most efficient way. Using machine learning and data-driven insights, the tool scores, segments and prioritizes patient accounts based on ability and propensity to pay. This allowed Stanford Health to recover revenue efficiently while providing positive patient experiences. Finding missing coverage was another strategy to boost reimbursement and avoid billing patients unnecessarily. Experian Health’s Coverage Discovery® solution finds billable primary, secondary and tertiary coverage using the Collections Optimization Manager AR file. Accounts that would otherwise have been sent to collections or written off can be identified and submitted for immediate payment. Listen in as Kristine Grajo, MBA, Director, and Teresa Ceja-Diaz, Vendor Management Analyst, at Stanford Health discuss how Experian Health helped their organization optimize their collections strategy. Outcome With Collections Optimization Manager and Coverage Discovery, Stanford Health achieved the following results: $4.1m increase in average monthly payments (2019-2021) Efficiency gains of $109k per month and $1.3 million annually Saved 672 hours per month by automating the screening of patient accounts, and processed 4,296 accounts 29% of all Coverage Discovery searches resulting in coverage found Stanford also incorporated PatientDial and had efficiency gains of 900 hours per month, while automating 27,000 outbound calls. A further $1.26m in annualized collections was recovered thanks to Experian Health’s Return Mail solution, which ensures that patient accounts contain only accurate, current patient addresses. With accurate patient information on file, the organization can process accounts with greater accuracy. This saves a huge amount of staff time while improving the patient billing experience. "We have received a lot of positive feedback with Collections Optimization Manager’s Return Mail solution because it gives us the most updated contact information. Whenever we need to notify the patient, we have the most updated addresses in our system.” — Teresa Ceja-Diaz, Vendor Management Analyst, Self-Pay Management Office at Stanford Health Care Find out more about how Collections Optimization Manager and Coverage Discovery help healthcare organizations accelerate collections and deliver an outstanding patient experience.

“We serve our patients well when we can spend time explaining their bills, what’s been covered by their insurer and what payment options they have, so they feel confident in what is owed and why.” Terri Meier, CHFP, CSMC, CSBI, CRCR, System Director of Patient Revenue Cycle at University of California San Diego Health (UCSDH) Challenge University of California San Diego Health (UCSDH) is one of the top health systems in the United States, ranked number one in San Diego by US News and World Report. With more than 9,000 employees, it generates over $2 billion in net patient revenue each year. Patient collections are managed by the Shared Business Office (SBO), which handles all queries about billing, financial assistance and payment plans. Providing a best-in-class financial experience for patients is the SBO’s top priority. The team implemented a three-part strategy to improve the patient billing experience and increase collections, focusing on people, processes and technology. They saw opportunities to use automation to support this. Solution The SBO implemented Experian Health’s Collections Optimization Manager to improve collections and deliver an outstanding patient experience. Using in-depth data and advanced analytics, this tool scores and segments patients according to their propensity to pay and automates the presumptive charity process, so patient accounts are handled efficiently. This helps UCSDH reduce the cost to collect by maximizing staff and agency resources. To further reduce the risk of bad debt, the SBO uses Coverage Discovery® to find billable commercial and government coverage that was previously forgotten or unknown. Listen in as Terri Meier, CHFP, CSMC, CSBI, CRCR, System Director of Patient Revenue Cycle at UC San Diego Health, discusses how their organization used automation to optimize patient collections and improve the patient experience. Outcome Between 2019-20 and 2020-21, UCSDH increased collections from around $6 million to over $21 million with Collections Optimization Manager. UCSDH also used segmentation data to improve outbound call campaigns. The team was able to create automated messages that can be sent to specific segments, so patients get the right information at the right time. By sending during time periods when patients were most likely to respond to calls, they were able to increase their collections rate. The screening feature also identified patient accounts that were eligible for Medicaid or charity support, deceased or bankrupt, and placed them in the correct work queue. The SBO leveraged Return Mail to run checks against patient addresses, to ensure that statements and refund checks were sent to the right place. Accounts with non-verified addresses were allocated to an auto-dialer for automated outreach. This helped reduce the manual labor required to find patient addresses, reduce bad debt and realize improved collections rates. By leveraging these tools, UCSDH has achieved: Increased collections from $6 million in 2019-2020 to $21 million in 2020-2021, a 250% increase Autodialer outcomes 2020-2022: 2,818 connects on return mail accounts 8% collections rate Return mail updates 2020-2022: 10,630 new and improved addresses found 55% hit rate Screening outcomes: 1,700+ deceased patient accounts identified between 2020-2022 2,700+ patient accounts associated with bankruptcy identified between 2020-2022 And thanks to Coverage Discovery, UCSDH has tracked down active insurance coverage amounting to more than $5 million in 2021. More than $4 million in coverage was found for patients under the California Medical Assistance Program. Had this coverage been missed, these amounts would have been written off as bad debt. Finding missing coverage outcomes:  $5M+ value of coverage found in 2021 19% hit rate in 2021-2022 (4% increase from the previous year) $4M+ value of Medi-Cal coverage found in 2021 9% hit rate in 2021-2022 for Medi-Cal scrubs Discover how Collections Optimization Manager and Coverage Discovery can help healthcare providers improve the patient billing experience while accelerating collections and reducing bad debt.

As household finances tighten, providers face a growing challenge to address patients’ financial needs while caring for their health. A new survey from LendingClub and PYMNTS found that 64% of Americans live paycheck-to-paycheck. That leaves little or no room for healthcare expenses and could mean there’s less in savings to tap as well. Healthcare organizations will need to take extra steps to provide patients with financial support during tough times. Survey results match up with Kaiser Family Foundation data on healthcare affordability. KFF found that 41% of Americans currently carry some form of medical or dental debt: 24% have bills that are past due or that they’re unable to pay 21% are paying providers directly over time 17% owe a bank, collection agency, or other lenders 17% have credit card bills 10% owe a friend or family member “The idea that patients are willing and able to access the healthcare they need regardless of cost is not in line with economic realities,” says Alex Harwitz, Experian Health's VP of Product, Digital Front Door. “But patients and providers may be encouraged to know that there are many digital solutions that can improve access to financial information and provide personalized pathways to meeting healthcare costs, so patients don’t have to go without needed care—or end up with medical debt they can’t manage and the massive stress that goes with it. By helping patients deal with the financial aspect of getting care and offering patient-centric payments, providers can also reduce the need for collections and bad debt.” How does a paycheck-to-paycheck reality affect healthcare and how can providers better support their patients? Here are a few things to consider: 1. There may not be enough money to cover unexpected medical expenses. Roughly half of the adults in the KFF study – including three in ten who do not currently have healthcare debt – are at risk of falling into debt. These respondents say they would be unable to pay a $500 unexpected medical bill without borrowing money. Identifying patients who might need additional information or help is one way providers can offer support. Coverage Discovery finds a patient’s available insurance coverage, including billable commercial insurance that may have been unknown or forgotten, and potential Medicare or Medicaid coverage, so both patients and providers get a clearer picture of what insurance will pay. Patient Financial Clearance is an automated solution that determines which patients are most likely to be able to pay prior to service and which patients might benefit from a payment plan or financial assistance. This solution helps healthcare organizations provide empathetic and supportive financial counseling by allowing staff to connect patients to the assistance programs they qualify for, and can even auto-enroll them. Because Patient Financial Clearance provides this information in real-time, providers can begin a conversation about costs and offer help early in the process when patients can benefit most. 2. Healthcare costs are difficult for patients to gauge. While the average consumer may be able to ballpark the cost of a new car or refrigerator, many can’t accurately predict the cost of a medical or dental procedure. Patients may not know what a complex procedure entails, what the charges for each line item might be, and what insurance will or will not cover. Facing the unknown can trigger anxiety, especially when finances are tight. Increasingly, providers are stepping up with pre-treatment estimates that give patients information about what their expected costs will be—even more so as new regulations require providers to share pricing information with patients and provide detailed cost estimates in advance of service. Patient Estimates is a web-based price transparency tool that generates accurate cost estimates patients can review prior to treatment, to help them understand their anticipated costs and begin planning for payment. 3. Patients who don’t think they can afford healthcare costs may avoid getting treatment. Providing accurate cost estimates is a critical first step, but with so many patients living paycheck to paycheck, estimates alone aren’t always enough. A 2022 survey from Experian Health and PYMNTS found that 60% of patients living paycheck to paycheck with issues paying their bills have canceled a healthcare appointment after receiving a high estimate, as have three in four millennials. “Providing patients with accurate cost estimates in advance of treatment is important to helping them understand and manage healthcare costs,” says Harwitz. “But adding digital tools that can help providers and patients explore their options is an equally important next step. Following through with additional support regarding insurance coverage, payment plans, and financial assistance can help ensure that patients don’t forgo needed care due to financial concerns.” PatientSimple is a self-service portal that allows patients to generate cost estimates, pay their balances using a card on file, set up payment plans, view and update insurance information, and apply for charity care. Behind the scenes, PatientSimple uses advanced analytics and Experian data to identify options for each patient, providing personalized support that can ease the patient's financial journey. Self-service digital tools are the key to providing better support for patients. Self-service tools empower patients to manage their healthcare expenses. Patients living paycheck to paycheck appreciate digital tools that help them work through estimates and bills. Digital tools like PatientSimple and Patient Financial Advisor, which provides mobile access to pre-service estimates and payment options, give patients access to financial information where they’re most likely to use it: on a computer or mobile device. “Solutions like PatientSimple and Patient Financial Advisor use data analytics to create personalized options that take a patient’s insurance coverage and financial situation into account,” says Harwitz. “Patients are not only getting a user-friendly interface, but also powerful support to navigate complex healthcare finances.” Financial health is inseparable from patient health. “The financial challenges facing patients living paycheck to paycheck and the providers working to serve them are increasing,” says Harwitz. “Fortunately, digital tools can provide real support for both patients and providers: pre-treatment estimates, digital access to insurance coverage and billing information, and personalized payment recommendations powered by data analytics. Automated processes mean these additional capabilities are available in real-time and don’t place a massive burden on human resources.” Helping patients mind their financial health is good for providers’ bottom lines: It’s key to maintaining revenue and avoiding costly collections and bad debt. Moreover, supporting patients’ financial well-being is an integral part of providing effective healthcare in the current economy. By recognizing financial realities and improving the patient payment experience, providers can help ensure that financial health enables patient health. Learn more about how Experian Health can help healthcare organizations better support their patients and improve the patient experience.

Whether by necessity or choice, the way patients navigate the healthcare payments system has transformed over the last few years. Healthcare’s digital front door swung open during the pandemic, offering patients far greater choice and flexibility in their use of digital payment methods. New legislation around surprise billing and transparent pricing gave patients greater visibility into the cost of care, improving their ability to plan for their financial responsibility. Many individuals switched between health plans and became responsible for a greater percentage of their healthcare bills. And the economic downturn continues to exert pressure on patients’ ability to pay, causing concern to patients and providers alike. Patient payment software can help ease these challenges. In this context, providers looking to attract and retain loyal patients must ensure the patient payments experience aligns with these changing needs and expectations. Clear communication, straightforward billing procedures and seamless payment options are essential to make it easier for patients to pay and protect provider profits. Here are 5 ways the right patient payment software can create a more satisfying patient experience and accelerate collections. 1. Offer clear and transparent medical billing processes As deductibles, co-payments and co-insurance arrangements become more complex, calculating patient financial responsibility is more challenging. Patients may find it hard to gauge what their final bill will be, prompting some to delay payments or even forego care altogether. A study by Experian Health and PYMNTS found that 46% of patients had canceled care after receiving a high-cost estimate, while 19% had experienced financial distress after spending more than they could afford on healthcare. Accessible, easy-to-understand billing procedures give patients a sense of control and encourage engagement in the healthcare process. This starts with reliable price estimates. In fact, around 60% of patients who received inaccurate pricing estimates would consider switching providers. With digital tools such as Patient Payment Estimates, providers can generate accurate estimates and give patients a clear breakdown of their financial responsibility before they come in for care. They also have the option to make secure payments via their mobile device. At the same time, insurance coverage discovery tools can be used to verify the patient’s insurance coverage and check for any forgotten coverage, so they have a better idea of what payer(s) will cover. Not only does this make the billing process more transparent and manageable for patients (resulting in faster payments for providers), but it also helps providers comply with new price transparency regulations. 2. Deliver flexible patient payment options Experian Health’s State of Patient Access surveys confirmed that patients want choice and control when it comes to paying for care. Experian Health President Tom Cox notes that “digital-first consumers are digital-first patients.” They want to see the “Amazon experience” replicated in their healthcare payments experience: “I will tell you, for myself as a patient, I much prefer to pay before I get there. Or I’d like to pay when I leave so that I don’t have to get the bill. If I do get the bill, I want to be able to pay online. What I don’t want is to fill out the slip with a check — the worst — or my credit card information and mail it to someone.” Digital payment methods can help providers remove friction in the payment experience by giving patients 24/7, self-service payment options, with options to pay by credit card, mobile wallets, online portals and peer-to-peer services. Experian Health’s suite of Patient Payment Solutions gives patients the flexibility they crave while helping providers increase patient satisfaction and accelerate collections. 3. Prioritize a personalized financial experience Just as there’s no one-size-fits-all remedy when it comes to clinical care, financial options must be tailored for each patient. Some patients will be willing and able to pay their bills in full and be keen to do so pre-service so they can forget about billing and focus on their health. Some may need to spread out payments into manageable chunks. Others may have no means of paying and feel unsure about their options. Patient Financial Clearance gives providers the data they need to customize payment plans based on each patient’s individual financial circumstances. With PatientSimple, patients can manage their payment plan through a user-friendly self-service portal, which allows them to generate pricing estimates, update insurance information, store credit card details, apply for charity care, combine payments to different providers and schedule appointments. This personalized service helps providers avoid missed payments and reduces the risk of having to involve multiple collections agencies, as patients have more confidence in their capacity to meet their financial responsibility. 4. Reduce patients’ financial worries While the uninsured rate has dropped, there are still more than 27 million Americans without health coverage. More will potentially lose coverage when the COVID-19 public health emergency ends. But even those with coverage may still worry about being able to pay for their out-of-pocket costs. Coverage Discovery runs automated checks to scan for any missing or forgotten billable coverage. Accounting for all possible coverage often reduces the patient’s financial responsibility and the accompanying anxiety that comes with a higher medical bill. Automation can also be used to pull together information from a provider’s chargemaster, claims history, payer contracts and patient benefits to generate accurate good faith estimates of the patient’s financial responsibility, which can eliminate ambiguity and help a patient better prepare for what they may owe. Read the report from Experian Health and PYMNTS, The Healthcare Conundrum: The impact of unexpected patient costs on care. 5. Improve operational performance Automation and digital tools also support operational efficiencies. Time-consuming manual tasks can be reduced or eliminated, allowing staff to focus on activities that need a human eye, or to support patients who need more personal assistance. Automation also reduces the risk of error, which can lead to contested bills and more work for staff to resubmit denied claims. For example, Kootenai Health used Patient Financial Clearance to automate presumptive charity checks and streamline a clunky workflow. They observed an overall accuracy of 88% in assigning patients to the right financial assistance program, reducing the number of accounts written off to bad debt. Sixty hours of staff time were saved, which were re-directed to priority tasks, eliminating unnecessary paperwork and improving the patient experience. Similarly, self-service payments allow patients to pay quickly and easily with minimum interaction with their providers. Not only does this reduce the burden on staff, but it also improves the patient’s financial journey. Patient payment software can increase satisfaction and accelerate collections What’s clear in these examples is that patient payment software and automation lead to faster, more flexible, and friction-free payment experiences for patients, while increasing recovery rates and operational efficiencies for providers. Find out how Experian Health’s Patient Payment Solutions help healthcare organizations reinvent patient billing and collections to boost revenue and improve patient satisfaction.

Hospital margins remain below pre-pandemic levels, leaving providers needing a revenue-boosting remedy. According to a recent report commissioned by the American Hospital Association, margins for 2022 may be down by 37% (at best) compared to before the pandemic, with expenses heading in the other direction. Could automated collections software offer some relief? Expenses are predicted to increase by nearly $135 billion over 2021, of which a significant slice is labor costs. At the same time, healthcare has a vacancy rate second only to the hospitality industry. Resource-saving solutions are essential to ease pressure on existing healthcare staff and maintain operational performance. Patient collections stand out as a ripe opportunity to use automation to improve efficiency, increase revenue and allow staff to make the best use of their time. By streamlining the billing and payments workflow, automation can facilitate faster payments, improve the patient experience and reduce the heavy lift on staff. How should providers leverage automated collections software to maximize the benefits and build a strong foundation for 2023? Automated collections software in practice: PatientDial One example of how automation can improve patient collections is PatientDial, Experian Health’s cloud-based dialing platform. Instead of relying on manual processes to call patients about outstanding balances, providers can use PatientDial to automate patient outreach with inbound interactive voice response (IVR) and data-driven outbound collection strategies, and take payments after hours. This offers three major benefits to providers: 1. Saves staff time and maximizes resources Making phone calls to patients is resource-intensive and time-consuming, especially when patients are increasingly hesitant to answer calls from unknown numbers. Alex Liao, Product Manager at Experian Health, says, “You have a significant portion of the population that won’t answer their phone, but you still have those that do. With a solution like PatientDial we can automate these contact attempts, so collectors don’t have to spend time dialing and leaving voicemail messages.” PatientDial offers inbound, outbound and blended call environments that can accommodate both live agent and messaging campaigns. In 2021, the automated dialer saved clients 900,000 labor hours, while automated voicemail saved more than 1.5 minutes per voicemail. Automation helps to streamline collection efforts and gives staff time to focus on accounts most likely to pay. To leverage this, PatientDial integrates seamlessly with Experian Health’s Collections Optimization Manager. This solution uses advanced data and analytics to segment accounts and routes them to the right collectors and agencies, further maximizing staff time. 2. Increases cash flow and new revenue opportunities The biggest advantage of automated collections software is expediting the payment process. Like many providers, Dayton Children’s Hospital faced difficulties growing in-house collections during the pandemic. Making patient calls was their most effective way of collecting payments, but it had become a lengthy and cumbersome process. After integrating PatientDial, staff was able to increase the number of calls per day from 50-60 to 600, resulting in a corresponding uptick in collections. New patient appointments increased by 70%, creating more opportunities to bring in additional revenue. Liao says, “One of the key takeaways here is that automated collections tools like PatientDial allow you to cast a larger net and maximize collections. The uptick in daily calls was a direct result of the ability to make automated contact attempts, leave messages, and connect those who answered the phone with a live agent standing by.” PatientDial helped clients collect over $50 million in 2021, collecting an average of $176 per transaction. 3. Improve patient engagement with automated collections software Jason Considine, Chief Commercial Officer at Experian Health, notes that it’s not just operational costs and staffing shortages that are giving providers cause for concern. He says, “Federal aid packages are being unwound and the country’s opening back up, so people are spending money on things they weren’t spending money on before. To compound that problem, we have inflation coming in at levels we haven’t seen in decades.” Pressure on household finances could cause patients to start missing healthcare payments. Any steps providers can take to make it easier for patients to understand, plan and manage their bills will pay off in the long term. Automated collections software such as PatientDial removes hurdles for patients so they’re more likely to pay and more satisfied with the process. “We have seen that when patients are provided with the right options, they typically do want to pay. But life gets in the way,” says Liao. “Having phone call reminders and self-pay options through a payment IVR helps increase collections by giving patients additional options that they can use when convenient for them.” PatientDial is just one tool in the box. When used alongside other patient-friendly digital tools, the results will be exponentially greater as the overall patient experience improves and further efficiencies are unlocked. For example, PaymentSafe® is a natural fit. This automates payment processing so patients can pay at any point in their healthcare journey. Every patient encounter becomes a collections opportunity. While financial forecasts may be daunting, there are opportunities to streamline and simplify patient collections to boost revenue and reduce expenses. Automated collections software punches above its weight by providing neat solutions that make better use of limited staff resources, improve patient engagement and boost revenue. Find out more about how PatientDial and other automated collections solutions can help healthcare organizations increase collections in 2023.

Consumers can order groceries or rent a car with just a few clicks, so paying for medical care often feels frustratingly complex in comparison. Bewildering pricing information and limited payment options leave patients with a poor impression of their healthcare experience, no matter how good their clinical care is. If patients are confused about what they owe and how to pay, they’ll end up missing payments and even delay care. Creating streamlined billing and payment processes and automating patient payments makes life easier for patients and providers, especially as they shoulder more healthcare costs. Here are 6 reasons why providers should consider automating patient payments with tools like PaymentSafe®, to increase patient satisfaction and accelerate collections. 1. Customized payment options One of the top reasons to automate patient payments is the ability to deliver a personalized experience to each patient. No two patients have the same financial situation, employment circumstances or desire to use digital technology. Why expect them to thrive with a one-size-fits-all billing and payment solution? Automated patient payment services draw on multiple sources of data to generate individualized insights at a scale, speed and level of detail that would be impossible manually. For example, Patient Payment Estimates produce instant, pre-service cost estimates based on the patient’s specific care requirements and coverage. It pulls in real-time payer rates and provider charges to make sure the patient has an accurate estimate from the start. By giving patients accurate, timely and relevant billing information and payment options, providers can increase collections earlier in the revenue cycle and meet patient expectations for a convenient consumer experience. 2. Reduced operational costs The longer a patient bill goes unpaid, the less likely it is to be recovered in full. Each additional billing cycle adds to the cost to collect. Staff must spend more time making outward collections calls, handling billing queries and issuing monthly billing statements. Automating patient payments eliminates much of this expensive extra work and reduces overall collections costs. Providers can automate manual tasks such as checking for charity eligibility or clearing up patient records, as well as, leveraging automated dialing and texting solutions to communicate with patients and help short-staffed teams focus on the tasks that matter. 3. Timelier patient payments The common denominator in these automated payment solutions is that they all help patients clear their balances sooner rather than later. Patients can move on with their lives without bills hanging over them, and providers will see a healthier bottom line. With convenient and compassionate tools, each patient encounter can be an opportunity to collect. For example, PaymentSafe® enables providers to accept secure payments anywhere, anytime, using eChecking, debit or credit card, cash, check and recurring billing, through a single, easy-to-use web tool. A connected healthcare collections ecosystem can deliver the data needed for pre- and point-of-service payments, including insurance verification, patient responsibility assessments, financing options, and payment methods. 4. Better balance management According to Experian Health and PYMNTS data published in July 2022, nearly half of consumers who canceled appointments last year did so because of cost concerns, while a fifth spent more on healthcare than they could afford. Making bills manageable with automatically generated payment plans will take a huge weight off their shoulders. And in another joint report, Experian Health and PYMNTS find that patients welcome more flexible ways to spread out the cost of care. Financial stability seems to influence whether patients embrace payment plans. Of those living paycheck-to-paycheck, patients who struggled to pay bills were twice as likely to use a payment plan than those who did not struggle to pay bills. However, lower-income patients may be underutilizing payment plans, as 9% had yet to pay the bill from their last visit. Manually setting up payment plans can be time-consuming and tricky to get right. Patient Financial Clearance automatically calculates the most appropriate and affordable payment plan for each patient, based on their individual financial situation. Those that are likely to be able to pay upfront can be encouraged to do so, otherwise, they can pay in more manageable chunks. Read the report: “Managing Healthcare Costs: How Patients are Using Payment Plans” 5. Reduce the risk of errors A significant downside to manually managed patient collection processes is that it’s all too easy to replicate errors. Patient information may be outdated, causing statements to be mailed to the wrong address. Active insurance may be undisclosed, leading to missed opportunities for reimbursement and higher patient bills. Inaccurate financial or employment data may prompt staff to chase accounts that have a very low chance of being paid. In short: errors are expensive. Automation solves these challenges. Coverage checks, pre-authorizations and eligibility verifications can be completed automatically, giving providers and patients greater confidence in billing breakdowns. Error-free billing means patients are more likely to pay their bills sooner, saving providers time and money across the entire revenue cycle. 6. Improve patient experience Ultimately, automation helps providers deliver a more streamlined, secure and satisfying patient experience. Experian Health’s State of Patient Access 2.0 survey found that more providers were offering alternative payment methods and upfront billing estimates to make payment easier for patients. They were also introducing payment options at the start of the patient journey, which gives patients control over how and when they pay, and minimizes the risk of late and missed payments. Patients feel empowered when they have more control over their healthcare spending; when they are unsure about what they owe or how they should pay, payments will take much longer. This is about more than prompt payments: 6 in 10 patients who received an unexpected bill or inaccurate estimate say they would switch healthcare providers for a better payment experience. Automating patient payments is table stakes These are just a few examples of the advantages of using automated payment services for patients. Patient demand for convenient and flexible digital payment methods is not going anywhere. Providers must keep pace or risk patient attrition later. Digital processes can make the collections team’s jobs easier and more satisfying and are viewed as a way to retain staff as managers continue to address the many challenges that remain from the pandemic and now, inflation and economic uncertainty. Experian Health’s suite of healthcare collections solutions is designed to be user-friendly to minimize training requirements, and collections consultants are on hand to support whenever needed. Tips to maximize the benefits of automating patient payments When choosing a patient payment solution, providers should look for ones that: use robust data sources offer tracking and reporting tools come with adequate training, support and service-level agreements deliver a seamless experience for patients in alignment with client product offerings. Collect payments anytime, anywhere, with Experian Health’s PaymentSafe®, the automated payment processing solution that helps you increase collections earlier in the revenue cycle and avoid bad debt.

The medical billing software outsourcing market is experiencing historic growth as providers respond to patient demand for digital payment options. The market’s value is expected to grow by five times over the next decade, from $11.1 billion in 2021 to $55.6 billion in 2032, according to a recent Future Market Insights report.  The pandemic has been the main driver of digital transformation in healthcare billing, embedding patient expectations for the same friction-free experience that has become the norm in other retail environments. By implementing medical billing software and digital collections solutions, providers can offer patients the flexibility and choice they desire. They can also capitalize on operational efficiencies ­– but only if they choose the right tools. Without the time or resources to undertake these activities in-house, many revenue cycle management teams are starting to outsource, in order to optimize medical billing processes, reduce costs and improve the patient payment experience. Choosing the right medical billing software Digital solutions can support every step of the patient’s financial journey, from receiving initial pricing estimates to paying at the click of a button. What criteria should providers consider when evaluating solutions that cater to patient demands for a better payment experience? Here are a few to look out for: Automation - Digital solutions do more than simply remove the need for paper-based billing. Software and machine learning can complete tasks to reduce the burden on staff and patients. Patient payment reminders, auto-filled claims forms and coverage checks are just a few examples of how automation can deliver speed and simplicity to patients, while saving staff time. User-friendly interfaces - A digital tool that’s difficult to use is never going to gain traction. Whether patient-facing or for use by front or back-office staff, user interfaces should be clean, simple and intuitive. Tracking and reporting - Digital billing solutions should offer the ability to monitor progress and generate instant status updates on payments and claims. With real-time insights, staff can further optimize collections and reimbursements. Reliable and secure data - Software and digital solutions are only as good as the data on which they’re built. Fresh, accurate patient data is essential. Data should be held in standardized and interoperable formats to streamline data exchange between different electronic records management systems. This will help to avoid errors, keep data secure and ensure compliance with HIPAA. A single vendor - A piecemeal approach can result in tools that don’t speak to each other. Instead, it makes sense to select a vendor that offers integrated systems for greater reliability and ease of use. Information from multiple billing and claims tools can be pulled into a single dashboard, so staff can capture the details they need at a glance. Setting up and optimizing digital solutions can be easier with a single vendor too. That’s why Experian Health offers consultancy and technical support to help users get started quickly. Here are 4 medical billing solutions that check these boxes: 1. Generate accurate estimates during patient registration with Patient Payment Estimates Providers can set the tone for a positive financial experience by deploying digital billing solutions from the start of the patient journey. One example is to offer patients accurate estimates of the cost of care before or at the point of service, so they can concentrate on treatment without worrying about unexpected bills. Patient Payment Estimates give patients a breakdown of their financial responsibility along with information about relevant payment plans and links to convenient payment methods. These can be accessed via a web-based tool or sent straight to their mobile device. Given that 6 out of 10 patients who received inaccurate cost estimates would switch providers for a better payment experience, tools like these could deliver a strong ROI. 2. Verify coverage as early as possible with Insurance Eligibility Verification and Coverage Discovery Verifying a patient’s active insurance coverage is a painstaking task when undertaken by hand. Staff must pore over payer websites and call insurance agents to check what the patient’s plan will cover. Automated tools like Insurance Eligibility Verification and Coverage Discovery can identify coverage quickly and accurately. Not only does this reduce the patient’s financial responsibility, but it also lowers the risk of uncompensated care and saves valuable time for staff. 3. Submit clean claims the first time with Claims Management Software Automating claims management takes a huge amount of pressure off staff teams. It also guarantees a higher level of accuracy than if claims were managed manually. Claims management software can automatically add patient information to claims, incorporate customized edits and review coding to ensure claims are correct before they are submitted electronically. Claims adjudication can be monitored in real-time to reduce the risk of denials. 4. Provide personalized payment plans and point-of-service payment options with PatientSimple Ideally, bills will be settled as early as possible. Neither providers nor patients want a protracted process of overdue statements and repeated phone calls from collections agencies. If patients are offered a choice of convenient payment methods at each touchpoint, they’re more likely to pay before or at the point of service. PatientSimple leverages Experian Health’s unrivaled data to identify the most suitable payment pathway for each patient and helps them manage it through a user-friendly, self-service portal. Patients can view statements online and pay balances immediately with cards kept on file. With the right medical billing solutions, providers can alleviate pressures on staff, reduce the risk of errors and support compliance with new regulatory requirements. But more importantly, it creates a healthcare experience that’s efficient, flexible and simple for patients, resulting in higher consumer satisfaction and faster patient collections. Find out more about how Experian Health’s medical billing solutions help providers maintain a healthy revenue cycle and meet patient expectations for a 21st-century consumer experience.