Tag: patient experience

Patients increasingly expect convenience and efficiency in all aspects of their lives, including healthcare. A study by Experian Health shows that 89% want the ability to schedule appointments anytime via online or mobile tools. The same survey showed providers are listening, with 63% offering self-scheduling and another 16% planning to go live with these tools in six months. That's good news for everyone, and not just because patients say they want more digital tools to manage their healthcare. Online scheduling addresses patient expectations by offering a range of benefits that traditional scheduling methods cannot match. However, these benefits aren't just for patients; healthcare providers that deploy online patient scheduling software experience four impressive benefits with a direct impact on their revenue cycle. What is online patient scheduling software? Online patient scheduling software is a digital tool designed to facilitate the appointment booking process for healthcare providers and their patients. This patient access technology replaces traditional over-the-phone scheduling methods with an efficient and user-friendly online system. The key features of patient digital scheduling platforms include: 24/7 appointment booking: Patients can schedule appointments at any time, day or night, providing flexibility and convenience that traditional methods cannot offer. Automated reminders: The software sends automatic reminders via email or SMS to reduce the likelihood of missed appointments. Real-time availability: Patients can view and select available time slots in real-time, ensuring they can find appointments that fit their schedules. Calendar integration: The software integrates with the provider's existing calendar systems to ensure that all appointments are accurately tracked and managed. Customizable scheduling: Healthcare providers can customize the software to reflect their specific scheduling rules, such as appointment types, durations, and provider availability. Manual scheduling frustrates patients and providers. Online patient scheduling allows patients to regain control while increasing their engagement in managing their health. Why do patients prefer online scheduling? Patients want online scheduling software because it aligns with their desire for convenience, efficiency, and control over their healthcare experience. One of the primary reasons to use online scheduling software is its round-the-clock availability. Patients can book appointments without office-hour restrictions. Online scheduling software allows patients to select time slots best suited to their schedules, minimizing the time spent waiting on hold during phone calls or in busy waiting rooms. Patients can easily see and compare availability, making planning their visits easier around personal and professional commitments. It also makes canceling or rescheduling appointments less of a hassle. One common issue patients face is forgetting about their appointments. Online scheduling software often includes automated reminders and confirmations via email or SMS, helping patients remember their upcoming visits. Some patients may also feel uncomfortable discussing their medical issues over the phone or in person at the front desk. Online scheduling offers a more private and discreet way to book appointments, allowing patients to select services without disclosing personal information to multiple people. Bringing digital efficiencies to healthcare scheduling leads to a more positive patient experience. One study showed that 28% of patients say care access has improved over the past year, even as more providers adopt these new technologies. But it's not just patients who benefit from online patient scheduling software. There are plenty of incentives for healthcare providers to adopt these tools. Healthcare providers benefit from online patient scheduling By adopting this technology, healthcare providers can streamline operations, improve patient satisfaction, and ultimately deliver higher-quality care. Experian Health offers online patient scheduling software that meets the needs of patients while benefiting providers. For example, Indiana University Health (IU Health) deployed the software across 16 hospitals and the largest network of physicians in the state. The organization leveraged the solution to increase patient volumes with minimal staff training, improving patient utilization by 114% within the first year. Today, four employees can handle patient scheduling for up to eight service lines. An unexpected benefit was the increase in referral management; the software enabled 600 monthly referral appointments, helping to generate new revenue for the system. These results are typical; most providers find the benefits of online patient scheduling software include: Reduced staff training time Improves the scheduling process for patients and providers Decreases patient no-shows Increases patient volumes and revenue Speeds up staff training One of the most significant challenges in any healthcare setting is training new staff quickly and effectively. Getting new staff up to speed rapidly is essential when severe staffing shortages are the norm. Experian Health's online patient scheduling software simplifies training. Its user-friendly interface and intuitive design reduce the learning curve for new employees to about an hour. The software provides guided workflows and real-time assistance, translating to less time spent on training and more time focused on patient care. Streamlines scheduling time Traditional scheduling methods can be time-consuming and prone to errors; 62% of providers say chronic staffing shortages exacerbate the problem. Online scheduling streamlines the entire process, cutting scheduling time in half over traditional methods. By allowing patients to book appointments online, the software reduces the back-and-forth communication typically required for scheduling. Automated reminders and confirmations ensure efficient appointment management. The calendar integration feature allows real-time updates and availability checks, providing a convenient booking process that enhances the patient experience. Improves patient no-show rates Patient no-shows can be a significant issue for healthcare providers, leading to lost revenue and wasted time. Experian Health's online scheduling software tackles this problem head-on. The software includes automated email or SMS appointment reminders, significantly reducing the likelihood of patients forgetting their appointments. Additionally, the ease of rescheduling allows patients to adjust their appointments without the hassle, further decreasing no-show rates. By keeping patients informed and engaged, the software helps ensure they attend their scheduled appointments, improving the clinic's efficiency and patient satisfaction. Josh Brown, Program Manager for Provider Match at IU Health, stated, “We've seen a reduction in no-shows and an increase in patient engagement. By leveraging technology and data analysis, the guided scheduling platform has helped deliver better care more efficiently and effectively.” Increases patient volumes and revenue Online patient scheduling directly contributes to increased patient volumes by improving scheduling efficiency and reducing no-show rates. More patients can schedule in less time, and the reduction in no-shows means fewer appointment slots go unused. The convenience of online scheduling can attract new patients who prefer digital interactions over traditional phone calls. These benefits lead to higher patient volumes and increased revenue for the healthcare practice. Today's digitally-savvy healthcare consumers require a different approach to scheduling services. Online patient scheduling offers them the convenience of DIY appointment setting and has some surprising benefits for healthcare providers, too, making these solutions a win for everyone. Ready to make the move to online scheduling? Contact Experian Health to get started! Improve patient scheduling Contact us

With over $220 billion in medical debt, patients in the U.S. are burdened by substantial financial obligations. These numbers also distress healthcare providers, who face cash flow and other operational challenges stemming from unpaid patient bills—and debt collection can further strain the relationship between care providers and patients. An efficient financial clearance process at the beginning of each patient encounter can benefit the entire system. But what is healthcare financial clearance and how can providers achieve it? What is financial clearance in healthcare? Financial clearance in healthcare is an administrative process that ensures patients understand their financial obligations before service delivery. It's often a manual workflow that involves verifying insurance coverage, estimating out-of-pocket costs, and discussing payment options or plans. The main objectives of financial clearance in healthcare are to prevent unexpected financial burdens for the patient, reduce the risk of unpaid medical bills for the provider, and streamline billing and payment. Common challenges with healthcare financial clearance Complex insurance policies, inaccurate or incomplete patient information, and lack of patient understanding of their own policy requirements are just a few of the challenges healthcare providers face in financial clearance. Not all healthcare providers have access to advanced technology or automated systems to streamline financial clearance, leading to reliance on manual processes that are prone to errors. Determining eligibility for financial assistance involves navigating complex criteria, which include assessing individual income, household size, savings, and medical requirements. When patients need help understanding their policy requirements, the educational burden often rests on the healthcare provider. Traditional manual methods of collecting and analyzing this data are prone to inefficiencies and inaccuracies, leading to missed opportunities to provide necessary financial support to patients. This makes the financial clearance process even more time-consuming, requiring significant administrative effort to verify insurance details, secure authorizations, and communicate with patients and insurers. Verifying a patient's insurance details during financial clearance ensures that the provider has the correct information about the patient's coverage, reducing the risk of denials due to eligibility issues. Financial clearance involves confirming that the patient is eligible for the services under their insurance plan. If eligibility is not verified beforehand, providers may deliver services that are not covered, leading to denials. Financial clearance also involves estimating the patient's out-of-pocket costs and ensuring the patient understands their financial responsibility. This process helps reduce denials related to unmet deductibles or co-payments, as patients are informed about their financial obligations upfront. Enhancing the healthcare financial clearance process improves revenue cycle management and significantly boosts patient satisfaction. As reimbursement denials continue to rise, healthcare providers have a vested financial interest in minimizing the financial uncertainties patients face early on in their healthcare journey. The use of technology to automate many of these manual processes allows healthcare providers to focus on minimizing financial uncertainty for patients, thereby enhancing their overall experience. Improve revenue cycle with automated healthcare financial clearance Healthcare providers can use technology to understand patient payment challenges and recommend the best financial pathway during the registration process. Providers like UC Health in Colorado leveraged Experian Health's Patient Financial Clearance software to write off $26 million in charity care. The technology integrates cleanly with the provider's electronic health record (EHR) to lessen the back-and-forth between systems during patient registration. Identifying the patients who need financial assistance upfront lessens the time spent pursuing bad debt and connects those who qualify for financial assistance with the right programs. Experian Health's Patient Financial Clearance solution fosters clear communication between the healthcare provider and the patient regarding coverage, costs, and payment expectations. This transparency helps in addressing potential issues that could lead to denials before they occur. Automation reduces bad debt and improves the patient experience Technology answers the question of 'what is financial clearance in healthcare?' with outcomes that include higher patient satisfaction and a better bottom line. Patient Financial Clearance automates screening to determine financial and clinical eligibility for each person at the first point of service. It answers critical questions such as: Does the patient qualify for financial assistance? What constitutes a realistic patient payment plan? Notably, the software helps set the tone for the patient intake specialist, approaching payment terms proactively and empowering everyone to take on their financial responsibilities early in the care delivery process. Patient Financial Clearance automates and streamlines manual workflows to optimize the revenue cycle. For example, this software can: Automate screening prior to service or at the point-of-service to determine if patients qualify for financial assistance, Medicaid, or other assistance programs, without relying on patients for information Leverage Experian’s comprehensive data and analytics capabilities to calculate the patient’s optimal payment plan amount based on the patient’s unique financial situation Predict propensity to pay using Experian’s proprietary Healthcare Payment Risk Score The benefits of Patient Financial Clearance for providers include: Improved point-of-service collections Lowered bad debt write-offs Increased staff productivity IRS 501(r) compliance Improved patient and staff experience For patients, Experian Health’s Self-Service Patient Financial Clearance option enables patients to conveniently complete eligibility checks at their own pace. Through a mobile and web-based platform, patients can submit screening forms and upload necessary documents, receiving real-time updates without the need to contact their healthcare providers. All information is securely stored, allowing staff to access application statuses as required. Automating financial clearance in healthcare transforms an unwieldy process into an efficient way to manage the delicate relationship between providers and patients. Technology can free up intake specialists to concentrate on creating a better patient experience and eliminate the frustrations surrounding collecting payment after the service is complete. Learn more about how Patient Financial Clearance can help healthcare organizations reduce bad debt by automating the patient financial assistance process.

Healthcare price transparency is high stakes for both patients and providers. With the average cost of a hospital stay for patients in the United States amounting to $2,883 a day, a patient's bill can quickly add up. Patients need reliable information about the cost of services as early as possible so they can plan accordingly. For providers, transparent pricing helps deliver a more compassionate patient financial experience and reduces the risk of missed revenue opportunities. However, it's also a compliance issue, especially with the introduction of the Hospital Price Transparency Rule. While the Centers for Medicare & Medicaid Services (CMS) found that 70% of hospitals are in compliance as of February 2023, the goal is to reach 100% compliance. Experian Health and Cleverley + Associates have joined forces to address the challenges providers may be facing. Riley Matthews, Lead Product Manager at Experian Health, and Jamie Cleverley, President of Cleverley + Associates, discuss what hospitals need to do to comply with the Hospital Price Transparency Rule. What is hospital price transparency and what is the Hospital Price Transparency Rule? The introduction of CMS price transparency requirements has brought about substantial shifts in the landscape of price disclosure for hospitals across the United States. Enacted as part of the FY19 IPPS Final Rule, these requirements were established in alignment with provisions outlined in the Affordable Care Act. Hospitals are now mandated to provide a comprehensive list of their current standard charges via the Internet in a machine-readable format, with updates required at least annually or more frequently as deemed necessary. This information can be presented in the form of a chargemaster or any other format chosen by the hospital, as long as it meets the criteria of being machine-readable. What are the new price transparency updates coming on July 1, 2024? As of July 1, 2024, CMS mandates that hospitals affirm the completeness and accuracy of their machine-readable file (MRF). This affirmation includes confirming that all applicable standard charge information, as required by § 180.50, has been included in the MRF. Furthermore, hospitals must assert that the encoded information is true, accurate, and up-to-date as of the specified date indicated in the MRF. Also starting on July 1, 2024, CMS will require hospitals to convert the contents of the MRF into a predefined template. This template is available in either .JSON or .CSV format. Additionally, there are new mandatory data elements, supplementing the previously specified ones (e.g., the five types of standard charges). Some of these new data elements have a delayed implementation date of January 1, 2025. What's the difference between the Hospital Price Transparency Rule and the No Surprises Act? The Hospital Price Transparency Rule aims to give patients clear, upfront information about hospital pricing, so they are empowered to make informed choices about their care. The No Surprises Act offers patients protection from surprise billing when they receive certain emergency and non-emergency services from out-of-network providers at in-network facilities. The two sister mandates work together to improve the patient financial experience and help patients navigate their financial obligations. What are the most common price transparency compliance challenges?  Cleverley says there are two main reasons why hospitals may be struggling to comply. First, there is some confusion about what is required to be disclosed (and how). To bridge this gap, Experian Health and Cleverley + Associates have created a standard methodology that satisfies the rule requirements. Second, some providers are hesitant to disclose pay rates amid concerns over financial viability and potential pressure to lower charges. However, the price transparency rule aims to enable market competitiveness and empower patients. Furthermore, making cost estimates freely available improves patient satisfaction by 88%, according to data from PYMNTS and Experian Health. A patient-centered approach to billing and payments not only supports compliance with price transparency regulations, but leads to faster payments and consumer satisfaction. In addition to Patient Estimates and Patient Financial Advisor, which offer patients accurate, pre-service cost estimates, there are a host of other Patient Payment Solutions that allow patients to choose payment plans, manage bills and make payments. How are Experian Health and Cleverley + Associates helping providers comply with the Hospital Price Transparency Rule?  The Hospital Price Transparency Final Rule requires hospitals to display payer-specific rates as a consumer-friendly list of 300 shoppable service items. Experian Health's Self-Service Patient Estimates solution helps providers compile these lists and deliver accurate estimates to patients in a clear and comprehensive way. This puts consumers in the driving seat when it comes to making informed healthcare choices and supports hospitals in providing clear, accurate and legally compliant pricing information. Providers must also make certain pricing information for items and services available as a machine-readable file displayed on their website. Cleverley + Associates has the necessary capabilities to deliver the machine-readable files quickly and at scale. By working together, both organizations deliver a holistic solution to meet price transparency mandates. Jamie Cleverley says this helps hospitals prepare for the changing environment: “It's more than compliance. It’s having trusted partners that are talking through and consulting with hundreds of hospitals across the country.” What is the best approach for providers to ensure price transparency compliance? Riley Matthews says that the first step for providers is to define a strategy that best fits their individual organization. They should identify best practice workflows based on their existing resources and intellectual property and partner with an organization that can bring solutions to areas where the system is lacking. The key is to execute the business strategy while prioritizing the patient experience. Experian Health and Cleverley + Associates can support hospitals in providing an efficient, consumer-friendly workflow, as well as the more robust backend concepts of the machine-readable file. Cleverley says, “We've created a methodology to display aggregated claim payment levels, simplifying the display of information for both hospitals and patients. Many solutions attempt to display just a list of payment rates, but the combination of those lines is really what's most relevant to patients.” For example, a patient coming in for an outpatient surgery has no idea what additional services, drugs and tests they may need. This solution looks at the statistical utilization of services to calculate the charges for that procedure, and then displays that value. This holistic approach meets “not only the letter of the law, but also the spirit of it.” What's next for price transparency? There has been a significant challenge around non-uniformity of data. Hospitals have been using different structures and file formats for displaying required information, but CMS has implemented a standardized file schema for use beginning July 1, 2024.  Cleverley + Associates has a file structure that conforms to the Medicare standard schema and is available to help hospitals understand the new requirements. As the penalties for non-compliance increase, providers need to be proactive in reducing the financial risks associated with price transparency non-compliance. Riley Matthews says that innovation and partnership helps providers get ahead of compliance rules and allows hospitals to focus on patient care. Find out more about how Experian Health and Cleverley + Associates are supporting healthcare organizations comply with the Hospital Price Transparency Rule and improve the patient financial experience.

If there's one topic that's sure to elicit groans from claims and billing teams, it's prior authorizations. Despite promising improvements overall, Experian Health's most recent State of Patient Access survey suggests that the efficient and timely management of prior authorizations remains a headache for providers, with 89% citing this as one of their top three improvement priorities in patient access. Obtaining pre-authorizations is time-consuming, often relying on antiquated manual systems that drag staff away from patient care. Ever-changing payer guidelines make an already frustrating process even more difficult. In this context, automating prior authorizations is an obvious choice for the 79% of providers who plan to invest in improving patient access in the near future. Why are prior authorizations required? Prior authorizations are when payers and providers determine in advance if the patient's insurance plan will cover a particular drug, medical item or service. Providers submit information about the patient's medical history and the rationale for the proposed treatment. The insurer evaluates this information and approves or denies the request. If a provider goes ahead without obtaining authorization, they are unlikely to be reimbursed for the cost of that care. The intention is to ensure that tests and procedures are safe, effective and high-quality. It's also a cost-control strategy, ensuring that expensive services are offered only to patients who really need them. Why do prior authorizations get denied? Insurers only approve prior authorization requests for treatment and services deemed medically necessary and aligned with their coverage policies. Authorization may be denied for several reasons: the treatment isn't covered by the patient's plan, the proposed treatment isn't considered medically necessary, or alternative, less expensive treatments are available. Denials often result from simple paperwork errors, such as incomplete clinical documentation or missed deadlines. Automating prior authorizations: an untapped opportunity The prior authorization workflow involves some of the most time-consuming and expensive manual processes in the revenue cycle, making it an ideal use case for automation. Yet, according to the Council for Affordable Quality Healthcare (CAQH), only 31% of providers use electronic prior authorizations. This contrasts with much higher adoption rates for other transactions: 94% use automation for eligibility checks, 98% for claims submissions and 90% for coordination of benefits tasks. With the amount spent on prior authorizations jumping by 30% between 2022 and 2023, switching to automated processes could save the industry hundreds of millions of dollars and many hours of staff time, among other benefits described below. Here are 5 benefits of automating prior authorizations: 1. Prevent costly claim denials and rework Without prior authorization, providers do not get paid. Failure to secure authorization was among the top three reasons for denied claims for almost half of the State of Claims 2022 survey respondents. Often, this is because the authorization does not cover all elements of a patient's treatment, or the information included in the claim submission does not match the original documentation that was authorized. With automation, it's much easier to ensure that all codes, documentation and records are accurate and complete, reducing the risk of claim denials. Automation also gives payers and providers a shared view of account information, minimizing the need for prolonged discussions about the status of authorization and rework requests. 2. Access a central payer database that automatically syncs with changing payer rules Revenue cycle management teams often struggle to keep track of changing payer requirements. Experian Health's prior authorization knowledge base solves this by collating real-time updates to payer requirements. Staff can check what's needed without needing to visit multiple payer websites and cross-check data by hand. Users also benefit from a guided, exception-based workflow, which notes whether submissions are pending, denied or authorized, and flags where manual intervention is required. 3. Improve operational efficiency Almost four in ten providers find timely and efficient management of prior authorizations challenging. Automating prior authorizations reduces the manual burden on staff, so resources and time aren't wasted on low-value activities. Providers can augment efficiencies by combining prior authorization software with other revenue cycle tools to create more coordinated and cost-effective processes. On a webinar about how AI and automation reduce claim denials, Skylar Earley from Schneck Medical Center commented specifically on how AI Advantage was facilitating more efficient prior authorizations: “[With AI AdvantageTM], we've seen the number of authorized outpatient visits increase by about 2.5%. For anyone that deals with prior authorizations and denials relating to prior authorizations, that's incredibly promising. Billers feel like they've got another tool in their belt. For people who spend hours on the phone with insurance companies, fighting for dollars and claims we believe should be paid, any leg-up is a big deal.” 4. Prevent dangerous delays to care with faster prior authorizations A 2022 survey by the American Medical Association showed that the authorization process leads to delayed and abandoned care and even severe adverse events, as patients and doctors wait to hear if paperwork is in order before proceeding with treatment. Automating prior authorizations helps ensure patients don't miss out on essential care because of administrative obstacles. Staff can shave an average of 11 minutes from each transaction, allowing them to initiate more authorizations in less time, and protect patients from the clinical consequences of rescheduling. 5. Deliver a better patient experience Aside from these obvious and significant health effects, the prior authorization workflow also influences patient perceptions overall: in the State of Patient Access 2024, just over a quarter of patients said authorizations were the main reason they considered patient access to be better or worse than last year. Automated prior authorizations free up staff to create a smoother clinical and financial experience for patients. Patients see their accounts processed quickly, with fewer errors and delays. When patients are certain that their insurer will cover their care, they can concentrate on their treatment rather than worrying about how and when it will be financed. Find out how Experian Health's automated prior authorizations help healthcare organizations get on the right path to reimbursement and make these benefits a reality in 2024.

Could patient text reminders play a key role in making healthcare more convenient and accessible for patients? Experian Health's latest State of Patient Access 2024 survey found that six in ten patients want more digital tools to manage their healthcare. Overall, it indicates a greater demand for more transparent, simpler processes. Patient text reminders make this a reality by reducing the cognitive load of scheduling and paying for care. With 98% open rates and an average response time of 90 seconds, text messaging is a simple but powerful engagement tool for providers. For the eight in ten providers gearing up to invest in digital patient access tools in the near future, sending patient text messaging reminders could be a smart choice. Here are three use cases to consider. Use case 1: Patient text reminders can boost patient collections For providers with squeezed margins, every cent counts. While healthcare affordability poses the biggest challenge for patient collections, outdated billing and payment processes hinder patient revenue overall. SMS (text message) reminders prevent unnecessary delays by gently prompting patients to settle their bills. They're direct, convenient and discreet, so they're more likely to be acted upon, as opposed to emails or phone calls that are easily ignored. Texting also supports a tailored experience. For example, Experian Health's PatientText solution integrates with Collections Optimization Manager to segment patients based on their needs and preferences. The Text-to-Pay feature sends patients personalized messages with secure links to payment options, so they can pay their bills when convenient without having to remember a username and password. Case study: See how St Luke's used Collections Optimization Manager and targeted patient outreach to increase average monthly collections by $1.7 million. Use case 2: Reduce no-shows with patient appointment reminders Almost 90% of patients say they want to be able to schedule appointments at any time via online or mobile tools. Automated text reminders ramp up the return on investment in online scheduling and mobile registration tools by reducing no-shows, optimizing patient flow, and ensuring patients get the care they need. Messages can include preparation instructions, so patients know exactly where to go and when, and if they need to fast beforehand or bring anything. It's much easier for patients to click a link in a text to confirm, reschedule, or cancel appointments, than to check their email or wait to speak to a call center agent. That's good news for call centers too – when more patients opt for self-service options, providers can scale targeted outreach while keeping call volumes manageable. Case study: See how IU Health transformed patient scheduling with self-service automation Use case 3: Patient text reminders increase patient satisfaction and care plan adherence with handy alerts Patients actively engaged in their health are more likely to follow through with treatments and care plans, leading to better health outcomes. Text messages can remind patients about post-appointment care, check-ups and medication refills to help them stay on track and reduce the risk of missed doses or appointments. Closing gaps in care and preventing avoidable complications is not just good from a medical perspective – it also reduces the risk of more expensive care being needed further down the line. However, one of the most significant advantages of using patient text reminders is creating a more organized and patient-friendly experience with little effort, benefiting patients and staff. Automated, timely messages through patients' preferred channels ensure they feel cared for and informed, without staff needing constant, high-touch follow-up. Staff members are free to focus on patient support and other revenue-generating tasks, instead of wading through endless admin. Read more: 5 benefits of automated patient outreach PatientText in practice: How one provider used targeted outreach to boost collections by nearly $2M One of Experian Health's clients offers a snapshot of what they've achieved in the year since implementing SMS-based patient outreach: $1.89M in patient collections via Text-to-Pay $168 collected per transaction on average 11K+ transactions via text These results show that offering patients the flexibility to engage with payment processes at their convenience leads to higher transaction amounts and more dollars collected overall. Take advantage of smartphone culture with patient text reminders Many patients have their smartphone with them 24/7, which gives providers a fantastic opportunity to improve patient engagement through automated text reminders. Whether the drive is to increase collections, improve patient flow, or create convenient patient experiences, it's clear that this relatively simple technology punches above its weight. Schedule a demo to see how Experian Health's patient text reminders solution, PatientText, can help your organization improve patient engagement and optimize collections.

The State of Patient Access 2024 marks the fourth installment of a series of surveys initiated in 2020, comparing patient experiences and providers' perceptions of those experiences. Experian Health's latest infographic highlights findings from the latest survey, conducted in February 2024, involving 200 healthcare revenue cycle decision-makers and over 1,000 patients. The study reveals an overall improvement in perceptions of access to care, indicating a positive trend in providers' efforts. However, there are still significant challenges ahead. Providers continue to believe access is better than what patients actually experience, a consistent finding across surveys. Check out the highlights in the infographic: Despite progress, there's a clear need to bridge the gap between patient experience and provider perception. How can providers turn their perceptions into reality for patients? Download The State of Patient Access 2024 report to gain deeper insights into patients' and providers' perspectives on access to healthcare.

Slow communications, confusing billing and a scarcity of digital options are the last things patients want to deal with when seeking medical care. Yet, this is exactly what happens for too many – and it's a significant financial risk for providers. This article examines why the patient experience matters and suggests four areas for improvement. Specifically, it looks at the digital tools that put patients in the driving seat and boost patient satisfaction and profitability. What is the patient experience? Improving the patient experience starts with answering the following question: what does receiving care feel like to patients at each stage of their healthcare journey? The patient experience includes all the touchpoints between patients and their providers, such as scheduling appointments, attending consultations, collecting prescriptions, and settling bills. There are also intangible components like empathy, respect, trust, and transparency, which shape a patient's lasting impressions of the healthcare organization. The experience goes beyond clinical care and face-to-face moments: back-end processes matter, too. Administrative workflows like insurance verification and claims management may be hidden behind the scenes, but they can soon influence what care “feels like” to patients if they're not running smoothly. Why is the patient experience so important to healthcare organizations? When patients have a positive experience, they're more likely to attend appointments, adhere to treatment plans and make healthier lifestyle choices. Health outcomes improve and the provider can build their reputation as a top choice for quality care. Satisfied patients are less likely to switch providers and are more likely to recommend services to family and friends. Everyone wants their loved ones to get the best possible care. The strong through-line from the patient experience to profitability tops the list for revenue cycle managers. Well-designed patient flows lead to better resource utilization, while improvements in attraction and retention rates directly benefit the bottom line. Positive patient feedback improves staff morale, so performance remains high. Prioritizing the patient experience is not only beneficial for patients, but is an essential strategy for financial sustainability. How to improve the patient experience in healthcare So, what do patients want? Experian Health's State of Patient Access 2024 report shows they want convenience, simplicity and choice, with 60% of patients saying they want more digital options to manage their care. They don't want to be passengers in their healthcare journey: they want to be the drivers, but with the support of a trusted guide. That's where digital tools come in. Here are four ways to use digital tools to improve the patient experience in healthcare: 1. Give patients speedy access to care with online self-scheduling Almost 8 in 10 dissatisfied patients say seeing their doctor quickly is their biggest challenge when accessing care. Online self-scheduling puts patients in charge and accelerates the process by making it easier for patients to find, book and cancel appointments, using an intuitive digital platform. Automated integration with the organization's business rules and calendars means patients only see appropriate appointments. This software maximizes patient show rates with appointments accurately matched to patients' needs. Case study: See how IU Health transformed patient scheduling with automation. 2. Simplify the financial experience with transparent pricing and payment plans Paying for healthcare is notoriously complex. Providers can simplify the patient experience with digital tools that deliver accurate pre-care estimates and flexible payment plans. Experian Health's Patient Payments Estimates solution uses data and automation to help providers give patients an early heads-up about what their bills are likely to be, and directs them to the most suitable financial pathway. In addition, offering hassle-free, secure payment options makes it easier for patients to pay their bills promptly, reducing the risk of bad debt for providers. Case study: See how Blessing Health System used integrated revenue cycle solutions to improve the patient financial experience and increase point of service collections by over 80%. 3. Personalize the patient experience with tailored outreach One of the major advantages of using digital tools is the ability to offer a personalized experience. These tools segment patients for tailored and targeted outreach based on their needs and preferences. This helps providers communicate with patients via their preferred channels and encourages prompt action. For example, text message and interactive voice response campaigns enable target outreach at scale to help accelerate scheduling and referrals and close gaps in care. Case study: See how Dayton Children's Hospital used PatientDial to increase outbound call efficiency. 4. Streamline back-office workflows for a frictionless front-end experience Finally, providers should consider how administrative processes affect what's happening in the front office and waiting room. Neglecting back-end processes can lead to bottlenecks, errors and inefficiencies that compromise the overall quality of the patient experience. Automated, data-driven revenue cycle management solutions not only eliminate time-wasting manual processes and help providers reduce errors and rework, but they also elevate the patient experience by reducing data errors and delays. Implementing tools like Patient Access Curator can also help take the pain out of registration and scheduling for patients, by capturing all patient data at registration with an all-in-one, single-click solution. By making every patient-provider interaction as simple and supportive as possible, healthcare organizations can build a patient experience that inspires loyalty, trust and engagement. With a bit of help from the right data and digital tools, providers can deliver a better patient experience and, in turn, secure financial sustainability. Find out more about how Experian Health's digital patient engagement solutions can boost patient satisfaction and provider profitability.

Prospects for US hospitals that closed out 2022 at a financial loss looked brighter by the end of 2023, prompting cautious optimism heading into 2024. An industry analysis published in October 2023 found that most hospitals were back in the black from March 2023 onward, while the economy more generally ended the year with a strong finish. That said, healthcare margins remain slim, and expenses continue to grow. Finding efficiency savings across all operations remains a top priority. That's where revenue cycle automation comes in. With revenue cycle automation, providers can eliminate many of the persistent pain points in traditional revenue cycle management (RCM). Staff no longer lose time to tedious manual tasks, patients get their queries answered faster, and managers get the meaningful data they need to drive improvements. And the biggest win? It's easier for providers to get reimbursed for the services they provide – faster and in full. What is revenue cycle automation and how does it work? Healthcare revenue cycle management knits together the financial and clinical components of care to ensure providers are properly reimbursed. As staff and patients know all too well, this can be a complex and time-consuming process, involving repetitive tasks and lengthy forms to ensure the right parties get the right information at the right time. This requires data pulled from multiple databases and systems for accurate claims and billing, and is a perfect use case for automation. Revenue cycle automation refers to the application of robotic process automation (RPA) to these repetitive, rules-based processes. In practice, this might include: Automatically generating and issuing invoices, bills and financial statements Streamlining patient data management and exchanging information quickly and reliably Processing digital payments Collating and analyzing performance data to draw out useful insights. Common RCM challenges Automation is already making headway in tackling some of the most pervasive challenges, such as: Stemming the rise in claim denials: Experian Health's State of Claims 2022 survey found that a third of providers had around 10-15% of their claims denied. These often result from errors made earlier in the revenue cycle such as incorrect patient information or overlooked pre-authorizations. RCM automation reduces the propensity for errors significantly. Streamlining patient access: Without a welcoming digital front door, the revenue cycle gets off on the wrong foot. Automation can be deployed in patient scheduling and registration to ensure patient information is collected and stored quickly and accurately. Improving collections rates: Self-pay patients (who are increasing in number) want clear, upfront information about what their care is likely to cost. Providers can find themselves playing catch-up if patients are unsure about what they owe. Automated tools that generate accurate estimates and support pre-service payment can build a more resilient cash flow. Expanding access to data insights: One of the biggest ironies in revenue cycle management is that more data is collected than ever, but managers are struggling to digest it and uncover actionable insights. RCM automation helps identify patterns in claims and collections. Six ways revenue cycle automation accelerates reimbursements Let's break down these opportunities into six specific actions providers can take to improve their organization's financial health: 1. Capture accurate information quickly during patient access Victoria Dames, Vice President of Product Management at Experian Health, says, “Patient access is the first step in simplifying healthcare and revenue cycle processes. Replacing manual processes and disjointed systems with integrated software solutions can reduce errors, improve efficiency, offer convenience and transparency to patients, and accelerate the healthcare revenue cycle.” Patient Estimates automatically compiles an accurate breakdown of what a patient is likely to owe before or at the point of service. It builds in prompt-pay discounts, financial assistance advice and instant payment links, so patients are more likely to pay sooner. 2. Simplify collections and focus on the right accounts Healthcare collections are a drag on resources. Automating the repetitive elements in the collections process helps reduce the burden on staff. Collections Optimization Manager leverages automation to analyze patients' payment histories and other financial information to route their accounts to the right collections pathway. Scoring and segmenting accounts means no time is wasted chasing the wrong accounts. Patients that can pay promptly are able do so without unnecessary friction. As a result, providers get paid faster. 3. Reduce manual work and staff burnout Chronic staffing shortages continue to plague healthcare providers. In Experian Health's recent staffing survey, 96% of respondents said this was affecting payer reimbursements and patient collections. While automation cannot replace much-needed expert staff, it can ease pressure on busy teams by relieving them of repetitive tasks, reducing error rates and speeding up workflows. Hear Jonathan Menard, VP of Analytics at Experian Health talk to Andrew Brosnan of Omdia about how AI and automation are addressing staff burnout and improving revenue cycle efficiency. 4. Maintain regulatory compliance with minimal effort While regulatory compliance may not directly influence how quickly providers get paid, it does play a crucial role in preventing the delays, denials and financial penalties that impede the overall revenue cycle. Constant changes in regulations and payer reimbursement policies can be difficult to track. Automation helps teams continuously monitor and adapt to these changes for a smoother revenue cycle – often with parallel benefits such as improving the patient experience. One example is Experian Health's price transparency solutions, which help providers demonstrate compliance with surprise billing legislation while boosting patient loyalty via a more compassionate financial experience. 5. Improve the end-to-end claims process Perhaps the most obvious way RCM automation leads to faster reimbursement is in ensuring faster and more accurate claims submissions. Automated claim scrubbing, real-time eligibility verification, more reliable coding, and easier status tracking all improve the chances of a provider being reimbursed promptly and fully. And as artificial intelligence (AI) gains traction, providers are discovering new ways to use technology to improve claims management. AI AdvantageTM uses machine learning to find patterns in payer behavior and identify undocumented rules that could lead to a claim being denied, alerting staff so they can act quickly and avert issues. Then, it uses algorithmic logic to help staff segment and rework denials in the most efficient way. Providers get paid sooner while minimizing downstream revenue loss. 6. Get better visibility into improvement opportunities Finally, automation helps providers analyze and act on revenue cycle data by identifying bottlenecks, trends and improvement opportunities. Automated analyses bring together relevant data from multiple sources in an instant to validate decisions. Machine learning draws on historical information to make predictions about future outcomes, so providers can understand the root cause of delays and take steps to resolve issues. A healthcare revenue cycle dashboard is not just a presentation tool; it facilitates real-time monitoring of the organization's financial health, so staff can optimize workflows and speed up reimbursement. Revenue cycle automation is the solution Just like any business, healthcare organizations must maintain a positive cash flow to remain viable and continue serving their communities. Together, these six revenue cycle automation strategies can cut through many of the common obstacles that get in the way of financial stability and growth. Learn more about Experian Health's revenue cycle management technology and see where automation could have the biggest impact on your organization's financial health.

For many Americans, access to healthcare is increasingly a question of affordability. There's no room for error when it comes to determining a patient's medical bill. Helping patients understand and plan for medical bills starts with calculating patient responsibility quickly and accurately. Incorrect charges, unexpected costs and confusing payment processes create poor financial experiences for patients. According to research by Experian Health and PYMNTS, patients are increasingly worried about their healthcare costs. 46% of those surveyed had canceled care after receiving a high-cost estimate, while 60% of those with out-of-pocket expenses said inaccurate estimates or an unexpected bill would prompt them to consider switching providers. As the stakes get higher, providers must reexamine how to calculate patient responsibility in medical billing so all parties are clear about who will pay for what. Providing that clarity will improve the patient experience, streamline patient collections and protect the organization from bad debt. What is patient responsibility? Responsibility for paying medical bills is apportioned between the patient who receives care, their insurance provider (if they have one), and government payers like Medicare and Medicaid (if the patient is eligible). “Patient responsibility” refers to the portion of the bill that should be paid by the patient themselves. Getting these calculations right is critical to the provider's revenue cycle. Determining patient responsibility starts during patient registration. Here, providers have their first opportunity to check that insurance details are up to date and ensure that the patient has not overlooked any active coverage. If the patient does not have coverage, they'll be liable for the whole bill (or will have to find charity assistance). If they do have insurance, the provider will liaise with their payer to check that the proposed care is covered under the patient's plan and establish any prior authorization requirements. Then, the provider can estimate how much of the cost of care should be reimbursed by the payer, and how much will fall to the patient. The amount paid by patients includes the following categories: Co-payment – this is a fixed, flat fee the patient pays toward their medical care at the time of service. If providers do not have accurate co-pay information available at the time of the visit, they may need to bill or refund the difference later. Not all health plans include co-payments, and those that do often specify exceptions. Deductible – this the total amount the patient must pay toward medical care each year before the payer contributes. For example, if a patient has a $1000 deductible, they must pay the first $1000 of medical bills that year, and any eligible costs on top of that will be covered by their payer or shared between the patient and payer. High-deductible health plans are attractive to patients who don't think they're likely to need care, as these plans often come with lower monthly premiums. However, if the patient does need care, they'll be left footing a greater portion of the bill. Coinsurance – this is the patient's share of remaining medical costs after paying their deductible. Out-of-pocket maximum – some health plans set an annual limit to the amount a patient needs to pay toward care, including co-payments, deductibles and coinsurance. Once that limit is reached, the payer will cover the remaining eligible expenses for the remainder of the period. Clearly, this is a complicated formula. To bill correctly, providers need to know whether the proposed treatment is covered by the patient's plan, how much the payer has agreed to pay for specific services, and whether individual service providers involved in the patient's care are in-network or not. Claims will only be reimbursed if all necessary coding and payer policy requirements have been met. Revenue cycle management tools to calculate patient responsibility Traditionally, providers have relied on teams of hard-working coders and billers to manually compile and review each claim. But with so many moving parts – not to mention frequent payer policy changes and staffing shortages – manual processes are no longer viable. When determining how to calculate patient responsibility in medical billing, providers should turn to automation and digital tools. This can help them augment their staff's capacity to calculate patient responsibility more efficiently and accurately and optimize patient collections. Here are a few examples of how they might do that: Automate insurance eligibility verification - Without understanding exactly what the patient's active coverage includes, providers will remain one step behind in the medical billing and claims management process. Payers are already using automation and artificial intelligence to fulfil their side of the equation, and providers cannot risk being left behind. Automating the verification process allows providers to capture up-to-date eligibility and benefits data, including the patient's co-pay and deductible amounts, to calculate the patient's responsibility pre-services. Find missing and forgotten coverage - As more patients switch health plans, more payers join the Affordable Care Act marketplace, and employer-based insurance changes, it's increasingly likely that the patient may not be 100% sure of their active coverage. With Coverage Discovery, providers can run quick, automated and repeated checks to see if any active coverage has been overlooked. This could drastically reduce the patient's responsibility, leaving them with a more affordable bill. Automate prior authorization - Many health plans require specific services to be authorized by the payer before being administered. Providers must check these requirements pre-service, or face a denied claim which could affect the patient's bill. Obtaining authorization from health plans before administering services can be slow and expensive, and often delays care. The Council for Affordable Quality Healthcare (CAQH) states that automating prior authorizations could save the medical industry $449 million per year (or 11 minutes per transaction). Automated prior authorization software gives providers real-time insights into payer requirements, so they can speed up reimbursement and give patients clarity over what they'll owe. Why use a patient cost estimator? With the necessary insurance information at their digital fingertips, providers can then use a patient responsibility pricer to calculate the patient's co-pays, deductibles and other out-of-pocket expenses. For example, Patient Payment Estimates is a web-based price transparency tool that generates personalized estimates for patients before and at the point of service. Patients get a comprehensive breakdown of what they'll owe, so they can plan for upcoming bills or even pay upfront. Patient liability estimator tools give patients more financial clarity, saving staff time and encouraging prompter payments. They're also an important compliance tool, and are specifically recommended in CMS advice on compliance with the Hospital Price Transparency Final Rule. Accelerate and streamline patient collections Early financial clarity encourages patients to pay sooner. This means it's more likely that those bills are paid in full, instead of lingering on the aged receivables list. In addition to upfront estimates, providers should make the payment process itself as easy as possible. This might include directing patients to payment plans or charity assistance, and connecting patients to convenient payment tools at any point in their healthcare journey. Inevitably, there will be some patients who simply cannot pay their bills. Collections Optimization Manager shows staff which accounts, so they don't waste time chasing the wrong accounts. By scoring and segmenting patient accounts based on the likelihood of payment, and adjusting as the patient's situation changes, Collections Optimization Manager helps providers manage resources more efficiently, while supporting a more compassionate patient financial experience. It also enables more effective use of collections agencies to minimize the cost to collect, and incorporates reporting and benchmarking tools to identify improvement opportunities. Find out how Experian Health's revenue cycle management tools can help providers calculate patient responsibility in medical billing, for a more compassionate patient experience and streamlined collections process.