Tag: patient access

Making phone calls, filling out paperwork, and chasing down debt shouldn’t take up the bulk of a healthcare organization’s daily schedule. Now more than ever, physicians have little time to provide high-quality care to their patients. In 2015, the American College of Physicians (ACP) put forth the Patients Before Paperwork initiative to address the burdens that these administrative tasks create for physicians and their staff. The ACP states that defining and mitigating administrative tasks is essential to improve an organization’s workflow and reduce physician burnout. Through utilizing healthcare workflow automation, you can improve productivity without overextending employees' duties. Instead, your team can spend more time caring for patients and helping them with the financial side of their experience, which is something both patients and doctors prefer. Easier access with automated healthcare solutions In the new wave of consumerism, there is a high demand for convenience and transparency in every transaction. Healthcare providers and organizations also face this pressure, but the industry has been slower to transform because patient care transactions are infinitely more complicated than online retail purchases. Despite the slow go, healthcare workflow automation technology and organizations are starting to catch up. For example, engagement is a defining factor for today’s healthcare consumers. However, engagement must be mindfully catered to specific situations. When it comes to scheduling appointments, patients actually prefer an automated healthcare workflow approach over talking to a human. Regardless of its form, engagement is still essential in all aspects of the care continuum, and physicians can find it hard to engage when every administrative task has to be completed by hand. If you’re still devoting time and resources to manual patient access tasks, you're not only falling behind in the competitive healthcare industry, but you’re also missing an opportunity to enhance the overall patient experience. Fortunately, countless tasks — scheduling, preregistration, registration, and admissions — are no longer paper-based and don’t require nearly as much hands-on involvement as they used to. Given this reality, automated healthcare solutions can and should take are of scheduling and other mundane tasks. Ultimately, automation will allow administrative employees to focus on other areas of engagement, like financial counseling for patients. Employees will have more time to help patients understand their financial obligations and perhaps set up a payment plan before procedures, avoiding the sticker shock of a surprise bill months later. The touchless approach In the Patients Before Paperwork initiative mentioned above, the ACP concluded that “excessive administrative tasks have serious adverse consequences for physicians and their patients.” At Experian Health, our automated healthcare solutions reduce those consequences by creating a touchless approach that only requires human intervention for exceptional cases. A touchless, automated healthcare workflow makes patient access predictable so you can spend more time serving patients. For example, our eCare NEXT® solution is a single platform that automates every step of the revenue cycle. Users only work on prescreened accounts with actionable follow-ups. Touchless Processing™ takes care of the rest through intelligent automation. You can effectively implement Touchless Processing throughout the rest of your organization by integrating eCare NEXT with Experian's other solutions: Registration QA When eCare NEXT is integrated with Registration QA, for instance, you can automatically access patients’ insurance eligibility in real time and identify registration inaccuracies early in the revenue cycle. This significantly reduces claims denials that can cut into revenue and take up more time to correct and resubmit. Payer-specific information can also be stored and automatically updated to ensure accuracy every time that payer comes up. Authorizations You can carry the touchless approach even further by expanding your suite of solutions with our Authorizations.The platform automates authorization management using the payer authorization requirements already stored and updated in the system. Authorization completes inquiries and submissions without user intervention to further reduce denials and expedite reimbursements. When done manually, administrative tasks related to orders, scheduling, preregistration, registration, and admissions are a drain on any healthcare organization’s resources. Minimizing staff involvement in these tasks improves the experience for physicians and patients alike, but it requires automated healthcare workflow solutions that can be seamlessly integrated into the workflow. With Experian Health’s Touchless Processing solutions, providers can exercise greater control over these tasks and significantly improve revenue recovery. This will give physicians and employees more time to focus on creating a more efficient, effective, and positive experience for everyone involved.

Multi-specialty, academic, non-profit healthcare delivery system increases productivity and improves resource efficiency The prior and pre-authorization inquiry and submission processes within patient access can be challenging for healthcare providers, as it’s often manual, cumbersome, and steps within the process can be missed or poorly integrated—frustrating both staff and patients. Experian Health’s Authorizations helped one of its healthcare delivery system clients increase efficiency and empower staff to spend more time with patients to discuss estimated liability and financial responsibility and provide them with payment plan options. “We needed an authorization solution that was integrated within our Epic workflow, easy-to-use and that our team could rally behind. We found that solution in Experian Health’s Authorizations tool.” —Director, Pre-service Center, multi-specialty, academic non-profit healthcare delivery system Inquiries are now automated and take place behind the scenes without user intervention. Submissions guide the user through the workflow, auto-filling all payer data and only prompting the user only when manual intervention is required. Hear more about this client’s success using Authorizations. Read the full case study.

During HIMSS17 in Orlando, Jason Wallis, Senior Vice President, Patient Access at Experian Health, sat down with IntrepidNOW to talk patient access and how Experian Health's solutions help providers across the revenue cycle. Excerpt below: "We have the eCare NEXT platform that drives a lot of our integration and patient access products. So anywhere from orders, all the way back to collecting payment from the patients, so right identity, checking eligibility, authorizations, medical necessity, patient estimates and then a tool to collect payment from that patient for those estimates. ...we’ve really taken this eligibility rail that has been pretty standard in the industry, and we’ve added a lot of content and innovation on top of those rails. So I almost call our clearing house a content network. So we drive more value in that transaction by normalizing, cleaning the data and enriching it with other data assets, so that downstream our clients and our products are better because of that advanced content. ...our integrated platform takes this data and be able to start chaining products together, and deliver back to the provider an exception based workflow that really has their staff only looking and working when something’s gone wrong. And the more we can automate around products and even products chaining off of other products, so eligibility to notice of admission, we are able to remove some of those manual single point solutions because it’s integrated in a single workflow." Listen to the full podcast Learn more about Experian Health's patient access solutions and eCare NEXT platform  

Last week, Experian Health announced the launch of Patient Schedule, an innovative new solution that allows for real-time integration across organizations to streamline active patient self-service appointment scheduling, powered by MyHealthDirect. During HIMSS17, Jason Kressel, SVP Product and Account Management of MyHealthDirect, sat down with IntrepidNOW for a discussion about online patient scheduling. Excerpt below: "I think healthcare organizations are recognizing that in order to be competitive that they have to offer services that patients are demanding. And so while offering online scheduling for patients is a different way for patients to access healthcare providers requiring a little bit of a change to the provider workflow, ultimately they’re seeing the value of doing that because patients are more adherent to the services that they are supposed to be obtaining, and they’re happier when they come into the physician’s office. So there’s definitely work that’s done with the healthcare organizations to explain the changes in workflow, and what it means to make online scheduling accessible for their communities. But at the end of the day I think they all recognize the value of offering those types of services and are slowly shifting to full adoption. ...So one of the things that we will be working on is, from that Experian patient portal once they have a patient engaged through that channel, allowing the patient to search for a provider and book an appointment directly from the Experian patient portal. Another example, Experian Health does a lot of work around order management, if a hospital creates an order for a service that should take place in an ambulatory setting, right now they can manage the order but they can’t schedule the appointment for that, so we’ll also be incorporating the ability to schedule directly from the Experian Health platform." Listen to the full podcast Read our press release, "Experian Health and MyHealthDirect team up to improve practice workflow with cloud-based patient scheduling across healthcare networks" Learn more about Patient Schedule  

Experian Health is pleased to announce that its Patient Estimates solution has joined the athenahealth® Marketplace, also known as  the More Disruption Please (MDP) program. Experian Health has participated in this program since the launch of the marketplace in 2013 (starting with our Contract Management offerings) and has worked with athenahealth to integrate its industry-leading capabilities into the organization’s growing network of more than 73,000 healthcare providers. Learn more about Experian Health’s Patient Estimates solution. Read the press release To learn more about athenahealth’s MDP program and partnership opportunities, please visit https://www.athenahealth.com/disruption.

The title of Best in KLAS is a highly coveted recognition of outstanding efforts to help healthcare professionals deliver better patient care. It is reserved for vendor solutions that lead the software and services market segments with the broadest operational and clinical impact on healthcare organizations. ~KLAS Enterprises LLC Last month, Experian Health’s eCare NEXT® platform was awarded the highest score in the Patient Access category of the 2015/2016 Best in KLAS: Software & Services report. This is the 5th straight year Experian Health has received the highest ranking in the patient access category—3 years as Category Leader in Patient Access – Eligibility Checking and now 2 years Best in KLAS in the broader Patient Access category. The KLAS award confirms our strong commitment to continually provide advanced technology and revenue cycle products for our clients, and consistently develop enhancements and new solutions with them. We are proud of the collaboration between our progressive clients and our dedicated employees to ensure clients provide the best patient care experience, and achieve payment certainty for every patient. It’s a great honor that our clients continue to hold Experian Health’s solutions in such high regard that we have been recognized consistently by KLAS year after year. View Press Release View full list of Best in KLAS winners and Category Leaders

Significant changes in health insurance coverage are delivering a good and bad news report for providers. The good news is the continuing decline in the number of uninsured Americans. As of January 2015, the current uninsured rate is at an historic low of 12.9%. Much of this decrease can be attributed to the Affordable Care Act (ACA), with 7.1 million people enrolled in a plan on the federal marketplace, as well as an estimated 2.4 million people who obtained insurance through state exchanges. Add to that young adults staying on their parents’ plans (3 million), another 10 million people who are covered through Medicaid and Children’s Health Insurance Plan (CHIP), job-based coverage and plans outside of the marketplace, and the picture should seem rosy. However, the bad news comes when these newly insured people begin using their benefits and are faced with deductibles, coinsurance and copays. Providers are seeing more patients with insurance coverage who find it challenging to handle these additional out-of-pocket expenses. Compounding the challenge is the increase in high-deductible health plans (HDHP) and/or health savings accounts. The number of people with HDHPs has risen from 19.2 percent in 2008 to 33.4 percent in 2014, as reported by the Centers for Disease Control and Prevention. Tackling the problem Healthcare providers not only have a mandate to provide care, most also are deeply committed to providing charity care when it is needed. However, in order to remain solvent, providers must protect their financial well-being by actively seeking reimbursement and payment when it is available and applicable. But, how can organizations strike the right balance? As a first step, having a system in place for assessment, enrollment and case management will not only help you maximize reimbursement by enrolling self-pay patients in Medicaid or qualifying them for internal charity care, it can also be used to document your facility’s charitable services. Key components to a well-orchestrated charity program include:  Screen for financial assistance using the most up-to-date qualification guidelines for Medicaid and other financial aid and charity programs. Ensures patients who are eligible for charity care, Medicaid and other assistance programs receive needed financial support. Determine a patient’s propensity to pay, so that you can evaluate payment risk, identify the most appropriate collection route and initiate targeted financial counseling discussions. Organizations can then maximize reimbursement dollars from Medicaid and other financial assistance programs and reduce uncompensated care and bad debt write-offs. Verify patient identity to reduce fraud risk, claims denials and the rate of returned mail – expediting reimbursement. This process streamlines the financial assistance screening and enrollment process to increase staff productivity as well as patient satisfaction. Through these strategies, organizations can more effectively identify patients eligible for charity, combatting ongoing patient financial responsibility challenges – or the bad news – while still capitalizing on the good news of more patients receiving coverage. Learn more about charity care initiatives by registering for our upcoming webinar, “Financial Screening in the age of the Affordable Care Act,” on March 11, featuring Brandon Burnett discussing Kaiser Permanente’s experience and initiatives and Kim Berg from Experian Health.

Meet Joe—a patient who is walking into a healthcare office, terrified of the news he might hear. He is confused and overwhelmed, not sure of where to turn for help. Joe isn’t entering a doctor’s exam room – he is actually walking into a hospital’s patient registration area, waiting to receive information about how much his procedure is going to cost. Although anxious about the procedure, Joe is even more concerned about its impact on the family budget, unsure of his insurance co-payment or what will be covered. He’s worried that he can’t afford to pay a large bill in one payment. His interactions with the registration staff over the next few minutes will set the stage for the remainder of his experience with the hospital. Now, let’s say the hospital realizes the value of having caring and compassionate financial conversations with patients at the start of the patient visit. Patient access staff quickly become the patient’s advocate while also improving the organization’s ability to collect from the patient and payer. In this instance, leveraging a data-driven approach allows staff to verify Joe’s identity and insurance coverage as well as provide an accurate estimate of his payment responsibility. The staff even can review data to assess his ability to pay and evaluate various payment plan and/or financial assistance options. Even after Joe is discharged, the hospital continues to employ a patient-centered approach to collections, using patient financial data to segment accounts that share demographic and financial profiles, rather than simply looking at balance amounts and number of days open. Joe’s financial data places his in the “most likely to pay” segment, indicating that he would not receive a payment follow up call until (for example) day 75 instead of the traditional call on day 45. This not only saves staff time and increases successful collections, it also preserves Joe’s satisfaction by eliminating unnecessary phone calls when he is likely to pay. Joe expected the hospital’s clinical staff to be responsive to his medical needs. When he found that the revenue cycle team was equally attentive to his financial needs, his satisfaction with the entire experience grew exponentially. It was fueled by a positive encounter that eased his mind about payment and allowed his to focus on his health. Using this proactive, personalized approach, the revenue cycle team had a major impact on both Joe’s experience and the bottom line. What is your healthcare organization doing to enhance the patient experience? Comment below to share some of your best practices.

There aren’t too many situations in which an individual purchases a product or service, but is NOT asked to pay for it right away. Healthcare, however, is somewhat unique in that regard, often avoiding a retail-based experience where patients receive service, but pay quite some time later, whether in full or the balance. Not surprisingly, this approach often times adversely impacts healthcare organizations in many ways. Best-case scenario, patient payments, while unpredictable, are received, but not in a timely manner and after a good deal of effort on the collections staff’s part. Worst-case scenario, the organization is left holding the proverbial bag, forced to write off bad debt, when payment could have been received if handled differently. In between, there are poor cash collections, increased revenue cycle costs and lower patient satisfaction. Organizations can avoid this perfect storm with a more precise approach to optimizing patient revenue. By leveraging tools that empower and improve upfront financial counseling communication, healthcare organizations stay one step ahead by accurately predicting patient responsibility payments and enhancing pre-service collections. When fueled by data and analytics, these tools offer a powerful two-pronged approach to minimizing risk and driving revenue: Avoid patient payment delays. Without knowing what insurance companies allow, many providers postpone collections until payer reimbursement is received. Healthcare organizations should instead have access to the latest contract terms, payment rules and fee schedules in order to identify patient and payer responsibility much earlier in the revenue cycle. Increase time-of-service collections. By proactively using patient payment data and current payer contract terms to calculate the amount owed by the patient at the time of service, organizations can effectively collect either a portion or all of that payment upfront. In the end, data-driven estimates of patient payment responsibility allow healthcare organizations to capture more revenue at the right time and boost cash flow. An added bonus is enhanced patient satisfaction because there are no confusing bills or ongoing collections calls, enabling a more personal experience for the patient. Hospitals have an opportunity to use data and analytics to improve the revenue stream and patient satisfaction. Learn about how Experian Healthcare Patient Responsibility Pricer can improve your collections on the front end of the revenue cycle and enhance the overall the patient experience.