Jason Considine, Senior Vice President, Patient Collections & Engagement, with Experian Health, sat down with Joe Lavelle from IntrepidNOW at HIMSS17 to talk patient engagement. Excerpt: "I think hospitals have spent tons of money really customizing the clinical experience for the patient over the last really 10 years and if you go into any hospital large hospital in America today, you’re going to feel like your care has been customized for you. But when you exit the care delivery mechanism and you get into the billing process, I still see providers treating patients kind of in a one size fits all method, and that’s where I see a lot of patient engagement changing from a financial perspective is using the power of information like what Experian has. We know what a patient’s financial disposition is, whether they can pay their bill or not, whether they qualify for the hospital’s financial assistance mechanism or not, and we can be more proactive in building that relationship and sending them offers to pay their bill and customize those types of engagements more appropriately for that you unique patient’s needs. We are the Best in KLAS vendor for patient access solutions, the eCare NEXT products suite. We are very focused on taking those tools that have been adopted by providers across the United States and making them patient facing. And so we have portals that can be accessed from any mobile device and from a desktop or laptop, and give the patient the ability to shop for care using self-service estimates. Pay their bill online and set up new payment plans and really communicate with their providers in the mechanism in vehicles in which they want to do it." Listen to the full podcast Learn about our Collections and Patient Engagement solutions.

Experian Health was honored to host Frank Abagnale, one of the world’s foremost experts on identity theft, forgery, and embezzlement, during our #JointheConversation radio show at HIMSS17. You’ll know Frank from the great movie and book, Catch Me if You Can.  Frank has been a consultant to the FBI for over 41 years. He also developed a fraud detection technology called the 41st Parameter that Experian purchased in 2013 and it now operates in 80 countries around the world. Frank was honored to be selected by HIMSS this year to lead a presentation called “Stealing Your Life” where he focused on identity theft in healthcare and represented Experian Health to discuss this topic. His presentation focused on the significance of fraud in today's healthcare world; illustrating the enormity of identity theft crimes and how they affect an individual's life in many areas including health insurance, credit, income taxes including refunds, banking, just to name a few. Hear Frank’s assessment of healthcare’s susceptibility to breaches, the current state of cybersecurity, privacy and identity theft, as well as helpful strategies to personally avoid becoming a victim of identity theft. Listen to the complete podcast Learn about our Identity Management solutions

The future for patient engagement becomes more clear every time we go out and do focus groups with providers and their patients. And what we are hearing from our clients and providers is that 40% of all their patients are on charity and 40% are on payment plans. So you are looking at about 80% of their patients needing charity or payment plans. And a lot of that is manual processes inside of the provider. And we also heard from a lot of consumers and patients that there is confusion about how they can afford their care. Clearly the thing that is on the top of our minds given this rising out of pocket expenses, is how can we anticipate what a patient needs when they leave the hospital using the Experian credit data? And then how can we proactively reach out to that patient with something that could be an activation offer for their charity care or their payment plan immediately after their service? We feel is this is a much more compassionate approach than what happens today. Leveraging the Experian credit data to be more proactive and predictive is a much more compassionate approach that will shift the patient’s behavior instead of the scenario where that patient takes their statement for $500 and put it under the stack of their bills. That one size fits all approach is not going to work anymore. We are moving to a very personalized patient engagement strategy that is more aligned with the patients’ needs and then give the patient all the digital automation tools so they can go and automate it and be done with it very quickly and they can focus on their health. Listen to the complete podcast Learn about our Patient Engagement solutions

There has been a lot of uncertainty with regards to what the future holds for healthcare in the U.S., but the reality is that the move away from transaction-based services where providers are paid by transaction or by interaction with their patients, into a world where some of those services will be paid as bundles, is a reality. At Experian Health, our perspective is that there isn’t going to be one single form of payment. There isn’t going to be only fee for transaction or only fee for value type payments.  There is going to be a variety.  And our solutions can help providers handle that. When we talk to our largest providers, they want to make sure that they are prepared for the future of healthcare, and that their payment and revenue cycle is robust enough that they can handle whether it is a fee for transaction interaction with the provider or with the patient as well as fee for value. In order to do that, they have to optimize their operations. There is a lot of belt tightening happening in the industry and people are trying to see and understand how best to organize, how best to analyze and facilitate that payment cycle. We believe that data and analytics are two of the key ways to do that. Our software tools as well as the data that we embed into that software helps optimize the revenue cycle. Listen to the complete podcast

On April 27, millions of workplaces, employees, parents and children will celebrate the 24th year anniversary of the Take Our Daughters And Sons To Work® Day program, which encourages girls and boys across the country to dream without gender limitations and to think imaginatively about their family, work and community lives. This national, public education program connects what children learn at school with the actual working world. Experian Health's offices will be participating in this program as part of its Women in Leadership initiative. Learn more about it and how your organization can participate.

In case you missed them, below are links to recently created videos of our clients and staff, as well as links to recorded webinars. New Videos Our healthcare provider clients share their experiences and best practices using Experian Health’s solutions. Watch Now Chris Lah from Cincinnati Children’s Hospital shares his insight around healthcare reimbursement challenges. Watch Now Rachel Papka from Steinberg Diagnostic Medical Imaging Centers outlines her orders management challenges and how her organization has overcome them. Watch Now Karly Rowe from Experian Health highlights the importance of matching, managing and protecting patient identities to safeguard medical information and reduce risk. Watch Now Tony Murdoch from Experian Data Quality explains how Experian's Data Quality Solutions can add value to our clients. Watch Now On Demand Webinars Patient Identification – The Challenges Healthcare Leaders and the Industry are Facing Today (HealthLeaders-hosted event). View Now (registration required) The Importance of Managing and Protecting Patient Identities (NAHAM-hosted event). View Now (registration required)  

In its first year of consideration, Experian Health’s ClaimSource® solution garnered the 2017 Category Leader title for claims management. This was achieved by having products and customer support that address the top issues in Patient Accounting, including: Declining reimbursement making it more important to ensure accurate payments Slow payment from third-party payers Having to make analytics-based key financial and operational decisions Constantly changing governmental mandates and payer requirements Managing the move from fee-for-service reimbursement to value-based reimbursement The challenge of finding skilled resources The continual stress to do more with less The Experian Health ClaimSource product suite addresses these challenges first by providing excellent products that are all seamlessly interfaced and can provide exception-based processing for: Automation of processing clean claims through the use of an expansive library of national payer edits The ability and willingness to create provider specific custom edits Expediting the follow up process thru the use of enhanced claims status detailed responses Enabling more efficient processing of denials by analyzing denials reasons and automating workflow Automating the payment posting process with customized posting files for handling splits and contractual adjustments Providing the best interfaces available for Epic clients for both hospital and physician billing offices We follow that up by offering superior customer support for our clients. By leveraging our size, experience, and multiple locations in Sacramento, California and our new location in Schaumburg, Illinois, we support clients from Hawaii to New York to Alaska to Florida and everywhere in-between. These two offices allow our clients to get great hands on support for implementations, training, extensive custom programming, as well as experienced billing analysts with decades of billing knowledge. We always thought our claims products stood out against our competition, but now KLAS has validated that for us. Ask your Experian Health account representative or email us at experianhealth@experian.com to find out how we can help your business office address your specific needs.

Why is missing coverage so detrimental? When patients are unable to pay, providers see an increase in self-pay receivables - 97% of hospitals reported an increase in self-pay receivables compared with the prior fiscal year. When providers can’t collect, the result is uncompensated care $35.7 billion – The amount of uncompensated care hospitals provided in 2015 (AHA, Dec 2016, http://www.aha.org/content/15/uncompensatedcarefactsheet.pdf) Registration errors and frequently changing insurance coverage contribute to an increase in self-pay receivables and bad debt: 20% error rate: Wastes an estimated $15.5B in claims that are never corrected and re-processed. Find previously unidentified coverage to reduce bad debt Experian Health’s Coverage Discovery® solution provides an efficient and trusted means for healthcare providers to reduce misclassified self-pay accounts. Our advanced self-pay engine maximizes the actionable coverage found for our customers across government and commercial payers, previously missed due to frequently changing insurances, data entry mistakes or patient misrepresentation to avoid high deductible health plans. The benefits to you: Make coverage identification more efficient Reduce number of accounts sent to collections & charity Maximize insurance reimbursement revenue Identify primary, secondary, & tertiary coverage Automate the self-pay scrubbing process What are our clients are saying about Coverage Discovery: [Video] Murry Ford, Grady Health System: “Coverage Discovery has brought in quite a bit of revenue for us—revenue that we would not have identified otherwise.” [Video] Mike Simms, Cone Health: “Since we’ve been using Coverage Discovery, we’ve received over $3 million in payments—more than a 300% ROI. It’s well worth every dollar spent.” Here’s why Coverage Discovery is different: Flexibility: Multiple delivery options easily fit Coverage Discovery into your revenue cycle Time matters: Find coverage on-demand Powered by Experian: Billions of data assets improve account specific intelligence and maximize found coverage Relevant: Confidence Scoring reduces data noise and removes potential false-positives to ensure staff time is focused on actionable accounts Uncover previously unidentified coverage with Coverage Discovery.

Challenge: a disconnected healthcare ecosystem Exchanging information across the healthcare ecosystem and achieving interoperability is a goal and challenge all healthcare organizations share. While regulations such as the Affordable Care Act introduced incentives and requirements to drive adoption of electronic medical records, they also highlighted a critical gap in healthcare – a universal patient identifier. Impact: Felt downstream across your enterprise The lack of a universal patient identifier, compounded by data integration challenges and the increasing fluidity of patient data, has created significant issues downstream – billing errors, redundant treatments and testing, HIPAA breaches, incorrect administration of treatments and prescriptions, and more. These issues contribute to the pool of preventable medical errors, which is currently the number three leading cause of death in the United States. Solution: Universal Identity Manager Experian Health’s Universal Identity Manager (UIM) accurately identifies patients and matches records within and across disparate healthcare entities, creating a universal patient identifier to facilitate information exchange. Drawing on more than 40 years of experience managing universal identifiers across various industries and leveraging Experian’s consumer demographic information, the UIM achieves higher match rates than traditional industry solutions. Integration flexibility The UIM is integrated within eCare NEXT®, but also supports various API options. It can also be leveraged in conjunction with biometric and traditional Enterprise Master Patient Index solutions. Batch: Receives, processes, and loads patient demographic information via patient data file. Starting with an initial historical patient data file in batch is recommended. The UIM algorithm is applied to accurately identify duplicate records and assign a Universal Patient Identifier (UPI) that can be used to facilitate information exchange across different healthcare entities. The UIM Batch is currently being offered at no charge to the entire healthcare industry. Duplicate Merge Tool: Provides a workflow tool to address duplicate patient records identified through the UIM batch. The Duplicate Merge Tool encompasses robust access and issue assignment management, configurable merge strategies, customizable search and filter capabilities, comprehensive audit trails, and postback or file output options. Search & Duplicate Medical Record Number (MRN) Alert: Leverages in process scripting to perform a real-time search the UIM as patient demographic information is being entered into an HIS during registration. The optimized patient record for each potential patient match is returned. If the search is circumvented, a Duplicate MRN alert will be created within eCare NEXT and prompt manual user review. Real-time search can also be facilitated through a direct API integration. Experian Single Best Record: Leverages an algorithm to look across all linked patient accounts that exist within a client’s enterprise database and aliases and addresses from Experian’s demographic information and returns back a patient’s single best record by demographic field. Data Analysis: Offers standard, premium, and custom reporting options with detailed data analysis across your patient data file. Learn more about Universal Identity Manager here, or contact your account representative for more information.