Tag: patient payment estimates

Experian is one of three credit bureaus to remove cleared medical debt from consumer credit scores, as of July 1, 2022. Previously, debts that were sent to collections would remain on patients’ credit scores for up to seven years after they’d been paid, making it harder to secure credit cards, loans and housing. Patients will also have double the time to manage unpaid medical debt before it appears on credit scores (up from six months to one year). Unpaid bills under $500 will no longer appear at all. It’s great news for the millions of Americans burdened by medical debt and financial stress and is one step to improving patient payments. The measures are expected to remove nearly 70% of medical collection debt from consumer credit reports. In a joint statement, Experian, TransUnion and Equifax said: “Medical collections debt often arises from unforeseen medical circumstances. These changes are another step we’re taking together to help people across the United States focus on their financial and personal wellbeing. As an industry we remain committed to helping drive fair and affordable access to credit for all consumers.” Healthcare providers can support efforts to ease financial pressures on consumers (and protect their own profit margins) in two major ways: by introducing transparent pricing and improving the patient payment experience. Help patients plan and understand medical bills with price transparency tools  July 1 also saw the implementation of the new Transparency in Coverage Final Rule, which places new responsibilities on health insurers to share negotiated rates for covered items and services. In theory, providing upfront estimates of the cost of care allows patients to make more informed decisions about their healthcare and plan for forthcoming bills with more confidence. In practice, it’s easier said than done. A report from August 2022 found that only 16% of hospitals are compliant with the earlier Hospital Price Transparency Rule. Non-compliance penalties aside, it makes good financial sense to help patients understand and plan for their medical bills: 9 out of 10 providers recognize that when patients have upfront estimates, they’re more likely to pay in full and on time. Digital and automated tools can make this easier to deliver. With Patient Payment Estimates, patients get a simple breakdown of their expected costs delivered straight to their mobile device, so they can plan – and even pay – in advance of treatment. Of course, estimates are only useful if they’re accurate, so this solution pulls from real-time price lists, payer contracts and benefits data so that estimates are as close as possible to the final bill. Provide an “Amazon-inspired” patient payments experience When it comes to patient payments, consumers want the “Amazon experience” – personalized payment options, easy-access digital payment methods, and above all, choice about when and where to pay. These three trends quickly gathered ground during the pandemic, and are set to outlast it. Providers looking to up-level the patient payments experience can’t afford to omit digital and contactless payment options. To help deliver this, Experian Health offers a menu of self-service, mobile-optimized payment solutions. For example, with Patient Financial Advisor, providers can help patients take control of their financial journey through a simple text-to-mobile experience. Patients get a text message with a secure link to details of their estimated financial responsibility and links to user-friendly payment tools. They can also be advised on appropriate personalized payment plans. Support patients to manage healthcare payments  For some patients, pricing estimates may influence their decision to access care in the first place. A new collaborative report by Experian Health and PYMNTS, released in July 2022, found that nearly 50% of consumers have canceled a healthcare appointment or procedure due to the high cost of medical treatment. The study also found that three-quarters of millennials canceled a healthcare appointment after receiving a high-cost estimate, as have 60% of consumers living paycheck to paycheck. Providers can use digital tools to identify patients who may need more assistance when it comes to paying for care and assign them to the appropriate pathway. Patient Financial Clearance screens patients automatically prior to or at the point of service to see if they qualify for financial assistance or charity support. It determines how likely a patient is to pay out-of-pocket expenses, and can calculate the optimal payment plan based on the patient’s specific circumstances. Another option is PatientSimple, which offers a user-friendly self-service portal to help patients apply for charity care and keep track of balances and payment plans. Of course, a huge amount of financial worry can be eliminated by simply tracking down missing or forgotten coverage, so the patient can relax knowing their bills will be covered. Coverage Discovery runs automated coverage checks across the entire patient journey to minimize accounts sent to collections and charity. In 2021, Coverage Discovery tracked down billable coverage in nearly 3 out of 10 self-pay accounts, amounting to more than $66 billion in additional revenue. Providers that create a patient-centered payments experience will not only deliver a better service to those needing care, but will be better placed to meet changing legislative requirements and strengthen their own revenue cycles. Find out how Experian Health’s digital patient payments solutions can help healthcare organizations transform the patient financial journey from a maze of dead ends and obstacles to one that’s clearly mapped out and simple to navigate.

Patients hit with a double whammy of rising costs and soaring inflation need to know where they stand when it comes to medical bills. Financially stretched patients often prioritize other household bills over healthcare payments, but delays can quickly spiral toward debt. When patients know their bills in advance, they’re better positioned to avoid medical debt – which is the thinking behind the No Surprises Act and other price transparency rules. Despite the benefits to providers, implementing accurate upfront price estimates is proving to be tricky. As of August 2022, only 16% of hospitals were found to comply with the federal price transparency rule, with the first financial penalties for non-compliance reported in June 2022. New measures that were recently announced will continue to address medical debt, and enforce price transparency rules more stringently. These turn up the heat on providers to find ways to simplify the patient payment experience. In a recent conversation with PYMNTS, Victoria Dames, Vice President of Product Management at Experian Health, highlighted three smart investments providers can make to help tackle the challenges associated with price transparency rules. Investment 1: Delivering accurate estimates Patients who do not see cost estimates before treatment are less satisfied than other patients. A study commissioned by Experian Health and PYMNTS found that patient satisfaction increased from 78% to 88% when estimates were available. But as Dames notes, estimates are useless if they’re inaccurate: “it's common to get an estimate today. It's less common to get a very accurate estimate.” She says that the renewed political focus on medical debt is likely to prompt investment in billing technologies to generate and deliver more accurate estimates. One such technology is Patient Payment Estimates, which offers patients a clear, accessible and easy-to-understand breakdown of what they’re likely to owe. It pulls from current chargemaster data and payer contracts and applies real-time benefits data for maximum accuracy. There’s no need for providers to manually upload price lists or call the patient to explain their estimates. It can even connect to convenient digital payment methods and provide payment plans, placing the patient in the driver’s seat when it comes to managing their financial responsibility. Investment 2: Implementing cutting-edge payment technology Dames says that once accurate estimates have been generated, the next big task is to enable consumer-friendly payment technology. She says, “Making the payment process simple and convenient will increase your likelihood for payment… it makes it easier for us as consumers to meet our financial obligations in a timely manner. A lot of providers are already in the process of reviewing and integrating technology to help support this.” Patients expect a variety of payment methods, similar to the convenient digital methods they use in retail environments. More than half of consumers say the pandemic changed how they pay for healthcare, with more choosing contactless cards, mobile wallets, online portals, and online peer-to-peer transfer services. Dames has noticed that “buy now, pay later” options are also entering the healthcare marketplace, which she believes will help to create a positive and transparent patient experience. Experian Health offers a suite of payment tools so that providers can collect all forms of payment anytime, anywhere. For example, Patient Financial Advisor brings together pricing estimates with user-friendly payment methods, so patients know what to expect and can make payments directly through their mobile devices. Investment 3: Optimizing collections with advanced data analytics Finally, Dames recommends that providers review their investments in collections optimization technologies. The goal should be to use a broad set of data to paint a picture of each patient’s past medical payments, recent financial situation, and current propensity to pay. Better data and analytics can help direct patients to the right payment plans. With more insights into each patient’s individual situation, providers will be able to see who needs more time to pay and who may be eligible for charity care. Data-driven tools such as Patient Financial Clearance can screen patients and assign them to the appropriate pathways, while PatientSimple helps patients manage their payment plans and apply for assistance if necessary. Experian Health works with more than 60% of US hospitals to improve revenue cycle management, so Dames knows that it’s a tough time for providers to update their workflows, systems and practices. When it comes to transparent pricing, Dames notes that regulations may be challenging for providers and payers. However, the subsequent investments will be instrumental in complying with price transparency rules and create patient-centered financial experiences: “The immediate path to better billing and payment processes may escalate pressures on providers right now, but it will yield better financial outcomes in the future for patients.” With the right technology partner, providers can tackle price transparency and increase patient collections. Find out how Experian’s data-driven patient estimates solutions can help healthcare organizations deliver more accurate pricing estimates and tackle price transparency rules.

New research from Deloitte reports that healthcare costs for the average American could jump from $1000 to $3000 per year by 2040, putting pressure on households that are already feeling financially squeezed. Concerns about healthcare bills could push patients to delay or even default on payments. With inflation on the rise, providers must find ways to create a compassionate financial experience for patients to maximize collections. That's where Patient Financial Clearance comes in. While inflation and economic pressures are systemic challenges, the impact is individual. This should galvanize healthcare providers to find out exactly how patients may be affected. Using that knowledge, providers can then tailor the financial journey to make it as straightforward as possible for patients to manage their healthcare bills, whatever their specific circumstances. With data on patients' ability and likelihood to pay, providers can tailor charity care checks and maximize collections by building a collections process with the patient at its heart. Create a compassionate collections experience with Patient Financial Clearance Improving patient collections starts with identifying patients that are unlikely to be able to pay and checking their eligibility for extra support. Traditionally, providers might use manual processes to calculate a patient's propensity to pay or entitlement to financial assistance. This might involve asking the patient to fill out a form with their financial details, calling the patient and the patient's employer multiple times to understand their income, manually checking their information against the Federal Poverty Level to see if it meets the threshold for full or partial charity support, and then having the patient fill out yet more forms. Such labor-intensive work is a drain on staff resources, and often a stressful experience for patients. Patient Financial Clearance helps create a more positive financial experience by automating eligibility checks. That way, patients can be assigned to the right payment pathway without delay. This solution also empowers patients with mobile text-based financial screening and provides them with updates on their charity status. It uses current financial data to screen patients to see if they're eligible for Medicaid, charity support or other financial assistance programs, prior to or at the point of service. Armed with this data, providers can offer the best possible support to these patients and even auto-enroll them in the right program. For those with medical bills, Patient Financial Clearance calculates an optimal payment plan based on how much the patient is likely to be able to afford, so patients are clear about what they'll owe and when. It can also suggest upfront fee collection when a patient can afford to pay but has been historically slow to do so. Personalizing the payment pathway with digital financial solutions Making sure patients don't miss out on financial assistance is just one way to use data and automation to personalize the payment process. Data-driven personalization should be a thread that runs through the entire financial experience, including: 1. Personalized upfront payment estimates Price transparency remains high on the agenda. Patients want to know their bills in advance so they can plan. Surprise bills lead to delays and frustration, to the detriment of both patients and providers. With Patient Payment Estimates, self-pay patients can generate personalized pre-service cost estimates so they can get their financial ducks in a row before treatment even begins. These estimates are based on the patient's individual insurance status, current payer rates and the provider's chargemaster data. The tool also incorporates any applicable financial assistance, applies prompt-pay discounts, and suggests convenient payment plans that fit the patient's individual circumstances. 2. Tailored payment plans for all Once the patient has their estimates, they'll want to know exactly when and how to pay. Some will be able to pay the full amount upfront, while others may need to spread out payments into more affordable chunks. Providers can maximize swift collections by ensuring that individual patients are directed toward the most appropriate option. Oftentimes, it may make sense to collect more payments upfront to alleviate collections costs downstream. One way to deliver this is through a self-service portal such as PatientSimple, which provides a one-stop-shop for patients to view their estimates, consider pricing plans and keep credit card details on file. Being able to plan in this way gives patients more control and avoids any confusion about payments. 3. Consumer-friendly payment methods When it's time to pay, patients want options. Not everyone wants to come into the office, send credit card details in the mail, or exchange details over the phone. Online payment portals, contactless payments and mobile wallets are increasingly popular. Therefore, providers need to offer convenient digital payment options to remain competitive.Offering a menu of payment options early in the patient journey means patients can “frontload” their financial admin, get payments out of the way, and focus on medical treatment. By giving patients control over how they pay, providers can reduce the risk of late and missed payments. 4. Timely and relevant communications If there's one action that can make or break a patient's perception of their financial experience, it's how their provider communicates with them. If information about medical billing is accurate, timely and compassionate, then the patient will feel more positively than if messages seem aggressive or contain errors. Getting this part right will improve patient engagement, drive faster patient collections and boost patient loyalty.Healthcare marketing data can be used to underpin a personalized communications strategy and help providers send the right message at the right time, based on the patient's preferences. When it comes to delivering the message, patient outreach solutions can send automated text and voice messages with bill reminders and links to payment methods to encourage prompt payments. Use Patient Financial Clearance to automate patient financial assistance Building a patient financial experience around the principles of personalization, empathy and convenience puts providers in a stronger position to maximize patient collections than with a one-size-fits-all approach. Find out how Patient Financial Clearance and other digital patient financial solutions leverage data and automation to identify and deliver what each patient needs, to improve patient satisfaction and increase the number of bills paid in full.

An efficient revenue cycle management (RCM) system is a win-win for patients and providers. Friction-free solutions that cover everything from booking appointments to paying bills create a more satisfying patient experience and allow patients to focus on their health. Providers can lower administrative costs and generate more revenue from data-driven billing and collections operations. To ensure the patient’s financial journey goes ahead without a hitch and avoid revenue leakage, the RCM system can’t skip a single step. Experian Health’s 10-step healthcare revenue cycle flowchart sets out the necessary ingredients for success. See the healthcare revenue cycle flowchart below: Step 1: Patient registration The healthcare revenue cycle flowchart begins with the patient’s first interaction with the healthcare organization. First impressions count. Patients want to be able to book appointments and complete registration quickly and easily, and providers that offer patient portals are seen as more attractive. Opening up the digital front door with online self-scheduling and self-service registration also helps providers increase operational efficiency and minimize manual errors that could lead to claim denials. Reliable patient intake software can verify patient identities, reduce manual processes and deliver a flexible patient experience – laying the groundwork for the entire RCM process. Step 2: Eligibility and benefits Next, providers need to check whether the patient’s insurance plan covers their expenses. To increase the likelihood of reimbursement, providers should give patients clarity about their coverage status and be vigilant about locating any missing or forgotten coverage. Coverage Discovery allows providers to check for undisclosed coverage at every patient touchpoint. By quickly uncovering previously unidentified coverage, bills will be cleared sooner with fewer write-offs to bad debt. This part of the RCM process is also a good time to help patients plan for their financial obligations. Patient Payment Estimates gives patients accurate estimates and links to financial assistance and easy payment methods, straight to their mobile device. With the right data and digital tools, providers can deliver a transparent, compassionate and convenient patient payment experience that encourages payment earlier in the revenue cycle and supports a healthy cash flow. Step 3: Data entry With RCM processes relying on data like never before, maintaining accuracy is paramount. Providers must be able to verify and protect patient identities to ensure the right information is linked with the right patient. Accurate data entry decreases the costs associated with medical billing errors, and improves interoperability as more patient data is created, collected and shared. A digital patient identification solution can build a single, accurate view of each patient, using a unique patient identifier to hold the information together like a golden thread. Automated patient enrollment using PreciseID® allows existing data to be auto-filled, while tools such as Universal Identity Manager maintains data in an interoperable format, to further protect against errors. Step 4: Prior authorizations Before treatment begins, providers must determine if prior authorizations are needed. If so, they must submit a request to the payer. Without prior authorizations, providers may see their claims denied, which increases costs, causes time-consuming rework, and creates a stressful experience for patients. With online prior authorizations, providers are guided through a workflow that automates inquiries, status checks and submissions. It auto-fills payer data using real-time information about each payer’s prior authorization requirements, stored in Experian Health’s pre-authorization knowledgebase. Prompts for manual involvement ensure the process is as efficient as possible, to expedite treatment and secure timely payments. Step 5: Patient encounter At the time of treatment, information about the services a patient receives will be added to their patient record. This sets the stage for accurate coding and billing. To ensure no essential information is omitted, providers must keep up to date with regulatory changes. For example, the Appropriate Use Criteria program introduces new requirements for providers ordering diagnostic imaging services. Providers should examine their workflows in advance to avoid any costly compliance errors. The patient encounter is also an opportunity to double down on creating positive patient experiences, and to anticipate any potential RCM issues. Communicating clearly about any changes to medical bills and checking again for coverage will keep the revenue cycle moving. Providers may also consider incorporating data on the social determinants of health to support efficient discharge planning and prevent high-cost readmissions. Step 6: Charge posting In the next step of the healthcare revenue cycle flowchart, providers must submit the claims to the relevant payer using the appropriate charge posting or charge entry process. Documentation must include a detailed breakdown of all the services provided to the patient, alongside patient information, history and insurance or payment plan status. Again, getting every detail right will secure more timely payments that match the expected amounts. Step 7: Coding and billing Before patient billing gets underway, providers must check payer codes for the services that have been delivered. Payers use diagnostic (Dx) codes, place of service (POS) codes, current procedural terminology (CPT) codes, Healthcare Common Procedure Coding System (HCPCS) codes and others to determine payable amounts. If codes are not inputted correctly, claims are likely to be denied. Automated claims management software can check that every claim is clean and error-free before being submitted. Experian Health’s claims management software incorporates standard government and commercial payer’s global edits as well as client-specific customized edits so providers can submit claims with confidence. J. Scott Milne, Senior Director of Product Management at Experian Health, says providers can leverage tools such as Claim Scrubber and ClaimSource to automate and prioritize claims to maximize reimbursement: “Both of these solutions are focused on the most important revenue cycle goal – to submit the claim correctly the first time. With the combination of Claim Scrubber and ClaimSource, healthcare organizations give themselves the opportunity to decrease denial rates, increase cash flow and decrease the overall accounts receivables.” Step 8: Claims management After the claim has been filed, the payer’s claims adjudication process begins. Payers will check eligibility, benefits, coding and contract rules to determine their financial responsibility. They may decide to pay in full, pay a partial amount, or deny the claim, with the reasoning set out in an Explanation of Benefits (EOB) statement. If the claim is denied, the provider needs to decide if it’s worth reworking and resubmitting the claim. Rework is expensive and time-consuming, so many providers use a healthcare clearinghouse to check claims before they’re submitted. Providers may also consider using a tool like Enhanced Claim Status, which submits automated status requests based on payers’ individual timelines, and provides responses that include the payer’s proprietary codes and descriptions. This facilitates early intervention into claims that are flagged for denial, which improves productivity and faster reimbursements. Providers also get detailed denial analysis and monitoring reports to pinpoint the root cause of denials, so they can be fixed promptly. Step 9: Payer Contract Management The complexity and volume of payer contracts can leave providers with little negotiating power when it comes to querying and collecting underpayments and delays. Providers need robust processes to audit payer performance and keep track of changing payer requirements to ensure timely reimbursements. Experian Health’s Contract Manager helps providers stay on top of changes to payer payment policies, identify patterns of non-reimbursement, and appeal denials in the most effective way. It identifies inconsistencies between pricing claims and paid amounts, so providers avoid missed revenue opportunities. Positive provider-payer relationships make the revenue cycle management process easier for everyone. With reliable contract management tools, communication and two-way accountability are much more effective. Step 10: Patient Billing and Collections The final step in the healthcare revenue cycle management flow chart is to bill patients for the remaining amount they owe. Balances are collected by in-house collections teams or outside collections agencies. Revenue cycle management software makes this process smoother and more efficient. For example, Patient Financial Clearance assigns each patient to the appropriate financial pathway based on their individual circumstances, while Collections Optimization Manager can be used to build custom segmentation models and workflows. That way, resources can be focused on the accounts most likely to yield revenue. Then, once the patient’s bill has been issued, collections software can be used to create a compassionate and convenient payment experience and complete the revenue cycle. Find out more about how Experian Health’s Revenue Cycle Management Solutions help healthcare organizations deliver outstanding patient financial experiences, optimize RCM workflows and increase cash flow.

When it comes to patient access, friction can lead to bad patient experiences. If patients can’t see a quick way to schedule a medical appointment when they visit their provider’s website, they’ll click away. If registration involves sitting in a waiting room with piles of paperwork, they’ll be reluctant to attend. If patients are confused by complex billing processes, they’ll put it off until they have the time and energy to engage. A recent survey by PYMNTS and Experian Health found that 61% of patients would consider switching to a provider that eliminates these pain points in patient access and offers more streamlined patient access, for example, through a patient portal. Beyond consumer satisfaction, convenient and flexible patient access makes financial sense for providers. It can help reduce no-shows, enable better use of staff time and accelerate patient collections. It also paves the way for higher quality care. After all, if patients are deterred from attending appointments and/or thinking about switching providers, it’ll take much longer for them to receive their diagnosis and treatment. What does “convenient and flexible” mean in practice? It means deploying digital patient access software that allows patients to complete intake tasks at a time and place that suits them. Self-service scheduling, automated registration, and personalized outreach around billing all help to create a friction-free consumer experience – and a more consistent cash flow. Rethinking patient access with patient-friendly digital solutions Consumer feedback in the survey by PYMNTS and Experian Health suggests there’s an opportunity to rethink patient access to meet patients’ digital expectations. Here are some examples of revenue-boosting swaps that will help create a patient access and intake experience that keeps patients coming in: 1. Instead of time-consuming queues and call center bookings → offer convenient online self-scheduling Around a fifth of patients say they’ve used digital scheduling tools, including patient portals, websites or text messages. Patients want to be able to schedule appointments when it suits them, rather than having to call within fixed hours to speak to a call center agent. Online self-scheduling allows patients to quickly find and book available appointments. Some providers may worry that these systems can’t account for their complex scheduling rules, but that’s not the case. Built-in guided search functions can factor in the provider’s scheduling rules, so patients are only offered appointments with the right providers. It’s easier for patients, and it’s far more efficient for staff. Relying on institutional knowledge and thumbing through giant binders of questionnaires can be stressful, time-consuming and error-prone. Online patient scheduling platforms eliminate these challenges. 2. Instead of patchy patient data → get accurate and complete patient identities One of the biggest challenges in patient access is capturing and utilizing accurate patient information. Typos, missing demographic details, out-of-date contact information and duplicate data all contribute to gaps and errors in patient identities. Without complete and reliable patient records, providers run the risk of delivering substandard care and suffer from preventable revenue loss. Instead of relying on manual data input processes, providers need digital systems that ensure the information added to a patient’s record is correct and complete. Experian Health’s Patient Identity Management solution pulls from the industry’s most reliable data sources to verify each patient’s information. It arms staff with automatic updates and alerts them to any potential discrepancies. Identity Verification helps improve the patient experience, minimize payment delays, and protect patients and healthcare organizations from identity theft. With more accurate data, collections are more efficient, leading to faster revenue recovery and fewer costly denials. 3. Instead of losing revenue to unnecessary write-offs → run automated coverage checks to find forgotten insurance If patients are unsure of their insurance coverage status, providers must invest time and resources to check for missing coverage. This pain point is currently in sharp focus, with the end of the COVID-19 Uninsured Program and the end of continuous Medicaid enrollment. As patients’ coverage status changes, providers must be able to run efficient checks for any potential missing or undisclosed coverage. Experian Health’s Coverage Discovery tool can run automated checks to look for billable coverage, as soon as the patient first interacts with the organization. Data-driven coverage discovery gives patients clarity about what they owe so they can plan ahead and allows more efficient use of staff time. 4. Instead of opaque pricing information → make it easy for patients to understand and pay bills Patients want transparent healthcare pricing. However, 15% of patients said they found it difficult to get accurate price estimates before coming in for care. The complaint was more frequent among the most digitally active patients – who are also more likely to switch providers based on the quality of digital services. Despite a recent push toward price transparency, there’s still a long way to go, with many providers struggling to comply with new federal price transparency requirements. Upfront pricing estimates make it easier for patients to understand and plan for their medical bills. With Patient Payment Estimates, patients get a clear, personalized breakdown of their expected financial responsibility sent directly to their mobile device. Patient Financial Advisor takes this a step further, by offering a text-to-mobile financial experience that connects patients with estimates, payment plans and contactless payment methods. Providers that offer convenient and flexible ways to pay will be best placed to protect profits. Discover how Experian Health’s digital patient access software solutions can help attract and retain satisfied consumers and bolster the bottom line.

Patient experience may not be the first consideration that comes to mind when you're looking to improve revenue cycle management (RCM). However, a positive patient experience can benefit RCM. It can make the complicated process of understanding and managing healthcare finances simpler and more seamless for patients—and facilitate an easy-to-navigate continuum of care that includes RCM. Financial transparency plays a significant role in building trust and confidence between patient and provider. Patients who may find it difficult to understand medical billing and health insurance coverage—and who are paying more out-of-pocket costs thanks to high-deductible health plans—appreciate accurate estimates and a range of convenient payment options. By optimizing back-end claims, billing, payment and collections processes, providers free up staff to provide individualized help to patients who need it. Strategies to bolster patient experience and RCM Patients who have grown accustomed to using digital platforms for everything from online shopping to food delivery, travel, managing finances and entertainment gravitate toward digital tools and expect a high level of functionality. In a Salesforce survey of 15,000 consumers, 68% of respondents said their expectations of companies' digital capabilities increased after COVID-19 drove more of their activity online. Providing a superior digital experience is now synonymous with good service, but healthcare is lagging behind other service sectors. For providers, automation and data analytics can streamline workflows and improve efficiencies. These factors are critical as staff find themselves under increasing pressure to provide accurate patient estimates upfront and to submit claims accurately to reduce denials. How can providers use the patient experience to improve RCM? Here are a few areas of focus to consider: 1. Offer consumer-friendly front-end technology Patients are looking for seamless digital experiences, where they are empowered to search out what they want, choose from a menu of options and pay effortlessly online. In a healthcare setting, they want to find and schedule their own appointments quickly. Providing new and existing patients with 24/7 mobile access to online patient scheduling is critical to early engagement. In fact, a new report from Experian Health and PYMNTS revealed that 61% of patients interested in using patient portals say they would switch to a healthcare provider that has one. Providing patients with an accurate estimate they can review in advance improves transparency and builds trust. This allows patients to ask questions and make decisions about how to pay on their own time and without pressure. Pre-appointment estimates might also offer patients the opportunity to pay conveniently online before their appointments or at the point of service, minimizing the need for post-treatment collections and reducing RCM costs. 2. Simplify and automate in-office technology Automation can boost the experience on both sides of the front desk. Automated processes simplify patient-facing tasks like registration and check-in while making back-office operations like data entry and authorizations more efficient. “When a patient submits photos of their insurance card and identification, software scrapes that information and inputs it into the system,” Serie explains. “This process is more convenient for the patient, faster and more efficient for staff, and reduces the potential for human error.” As healthcare providers continue to experience staffing shortages, automated systems can offer greater workplace flexibility. That's helpful for providers that need to flex their resources, but also for employees who want more options on where and when they work. 3. Provide price transparency and financial information to improve the patient experience In a Policygenius consumer survey, 26% of respondents said they have avoided care or treatment because they were unsure what their insurance covers. Patients might be forgiven for feeling confused and frustrated – healthcare bills are not always patient-centric. In fact, many consumers report a low level of insurance literacy and, unless told, don't know in advance what medical procedures are likely to cost. At the same time, out-of-pocket costs are rising, raising the stakes and increasing the likelihood that medical bills will pose a significant financial challenge. Outlining estimated costs prior to service can help patients understand their expected out-of-pocket payments. Accurate patient payment estimates take away some of the sticker shock and give patients an opportunity to discuss coverage with their insurance companies, choose the right payment methods, or arrange for payment plans before treatment happens. 4. Allow for online bill payments Frictionless payments are now the norm, online and in-app. Experian Health's PatientSimple solution offers healthcare organizations a suite of tools to simplify payment. Using a healthcare-specific algorithm, PatientSimple provides personalized, data-driven insights that help providers deliver the right messaging and payment options, including: Price estimates based on insurance coverage and payer's negotiated rates Guest payment option for patients who don't want to set up an account Online payments and payment plans E-statements, online account access and email payment reminders Qualification for financial assistance A smoother path to payment increases the chances that patients will pay pre-appointment or at the point of service. By offering patients more and better payment options providers can increase up-front revenue and reduce the need for collections. 5. Enable self-service Frictionless payments are just one facet of helping patients help themselves. Enabling the tools that create a “digital front door”—including the ability for patients to register and check-in online, access a virtual waiting room and make “contactless” payments—can boost engagement and give patients greater choice, control and convenience. By mapping a patient journey that flows seamlessly between virtual and in-person interactions, providers can set the stage for receiving payment earlier in the process. This can also help with outreach to patients post-care for follow-up and payment, if necessary. 6. Ensure coding and billing accuracy Clear, accurate patient billing is the goal, but keeping up with changes across multiple payers is an ongoing challenge for healthcare providers. New products, mergers and acquisitions, policy and procedure changes all create the potential for errors, denials, delay and lost revenue. Experian Health's Payer Alerts helps notify providers of payer policy and procedural changes with a daily digest email and an online portal. A simplified estimate process with fewer revisions streamlines the RCM process; it also helps patients avoid confusion, which degrades the patient experience and may cause patients to delay payment. 7. Optimize bill collections Collections can be one of the most difficult parts of healthcare RCM. On the patient side, post-treatment collections feel like a hassle; they may also become a source of significant financial problems. For providers, collections can be costly and time-consuming. Optimizing collections with automation and data analytics can streamline the process and improve outcomes. Experian Health's Collections Optimization Manager uses specialized scoring algorithms to segment and prioritizes accounts based on the likelihood they'll be able to pay. Automated billing and outreach make collections less onerous for staff, while automatic updates keep accounts and communications current. For patients, providing convenient digital payment options takes some of the friction out of the payment experience and removes at least one barrier to bringing an account current. Patient experience and RCM go hand in hand Improving healthcare RCM is certainly not the only reason to work on improving the patient experience. Enhancing the patient journey across the care spectrum can help providers engage new and existing patients, offer the digital tools and seamless experiences they've come to expect, and reduce their anxieties over medical costs. At the same time, using RCM solutions to bolster the patient experience means new efficiencies for staff and, along with this, expanded opportunities for work flexibility and greater success at managing the revenue cycle. Contact Experian Health to learn more about optimizing your patient experience and improving RCM at your organization.

Healthcare isn’t known for its consumer-friendly payment processes and trails behind other service sectors when it comes to matching consumer preferences for convenience, choice and control. Is healthcare about to change and adjust to patient-centered payments? Healthcare still gets the most votes as the industry that makes payments the hardest, but it’s certainly evolving. In large part, this is a result of the pandemic. Providers were forced to modernize processes and embrace contactless technology that consumers are familiar with, from their purchasing experiences in retail, hospitality and banking. Consumer expectations for better payment tools were already there – the pandemic demanded the experience met the expectations. However, patient-centered payments is more than simply catering to consumer preferences. The quality of the healthcare payment experience can affect how and when patients receive care. If patients are worried about managing medical bills alongside their other household financial responsibilities, they may be tempted to delay or forego care. If making payments is time-consuming, they may put off dealing with bills. If their provider doesn’t offer convenient tools to help with financing, payment plans and mobile payments, patients may jump ship to a provider that does. Providers will need to overhaul their existing payment system and give consumers what they need or risk losing revenue and patient loyalty. So, where are the opportunities for providers to deliver a more patient-friendly payment experience? Experian Health’s State of Patient Access 2.0 survey showed that patients are looking for clear, transparent healthcare pricing, payment plans and support, as well as faster ways to pay. Simplifying the patient payment journey is key. Here are six ways providers can make healthcare payments easier and faster in 2022. Think like a consumer It’s likely consumerization of healthcare payments will take place in 2022. Providers must put themselves in the patients’ shoes and imagine the ideal payment experience – fast, flexible and secure. Jason Considine, Senior VP at Experian Health, says providers are already seeing the benefits of a digital-first approach that gives patients a variety of payment options. He notes, “In one of our surveys last year, 93% of providers said improving the patient experience is a top priority for them. We’re aware of the need to change and modernize payments.”Experian Health’s Patient Payment Solutions help providers simplify the patient's financial journey with self-service, mobile-optimized payment options. This allows consumers to manage their healthcare payments as easily as they pay for groceries. Give patients more mobile payment options As more health services are delivered in retail health clinics, such as CVS and Walgreens, providers must offer the same convenient digital payment options to remain competitive. More than half of consumers say the pandemic affected how they pay for healthcare. Contactless payments, mobile wallets and online portals have become popular choices. Peer-to-peer payments such as PayPal, Venmo and Google Pay also saw increases in usage in 2021. Forward-thinking providers are offering mobile payment solutions with tools such as Patient Financial Advisor, which allows patients to see estimated cost breakdowns and take advantage of payment plans. Provide a compassionate patient experience with automated reminders and prompts Navigating healthcare payments can be stressful for patients. As a result, they’re more likely to choose a provider that offers a compassionate experience. An integrated payment solution can act as a “financial concierge” for patients, guiding them through the payment experience with appropriate prompts and reminders, through their preferred communication channels. Patient Outreach solutions help patients stay organized with timely bill reminders, self-pay options and automated text and voice messages. Consumer data supports these tools by giving providers insights about a patient’s ability to pay, so they can engage in supportive financial conversations to help the patient decide on their next step. Offer transparent pricing and upfront estimates Experian Health’s State of Patient Access 2.0 survey showed that price transparency had improved considerably between 2020 and 2021, and remains important to consumers. Demand for healthcare price transparency will continue to grow, so providers must keep pace with developments. Giving patients an accurate cost breakdown straight to their mobile device means they can pay faster and more efficiently. Patient Payment Estimates and Patient Financial Advisor work together to help patients understand their financial responsibility. This can help them plan for upcoming bills and pay immediately if they choose. Patients get a pre-service, personalized pricing estimate based on real-time insurance status, payer contracted rates and provider pricing. Use data to prescribe the right financial pathway Not all patients are able to clear their entire bill in one payment. Personalized payment plans are an ideal way to help patients manage their balances and apply for charity assistance if necessary. PatientSimple is a consumer-friendly self-service portal that allows patients to generate pricing estimates, figure out pricing plans, and store cards securely on file, all in one place. Not only does this eliminate much of the confusion and frustration that causes negative healthcare experiences, but it also helps increase patient payments and reduce providers’ time and cost to collect. Run repeated coverage checks to give patients financial certainty Jason Considine notes that “patient populations shifted dramatically during the pandemic, with many individuals losing jobs, finding new jobs, and moving around the country. Their ability to pay has also shifted, so providers are going to need to adopt tools and technologies that help them validate and understand each patient’s insurance coverage.” Solutions like Coverage Discovery can help providers run checks throughout the entire patient journey to find missing or forgotten coverage. This gives patients certainty that their bills are covered and helps providers collect faster. Other tools, such as Collections Optimization Manager, can help providers adopt a targeted collections strategy and segment patient accounts based on propensity to pay. Ultimately, getting paid faster comes down to creating the best possible patient payment experience. The more compassionate, convenient and flexible this experience, the easier it will be for patients to pay and the more likely it will be that bills are settled in full. Find out more about how Experian Health’s patient-centered payments solutions can help providers increase patient collections in 2022.

The final blog of our post-COVID-19 patient journey series explores how patients have come to expect convenience, flexibility and transparency when paying for healthcare. How can providers ensure the real-life patient payment experience delivers? Read the full white paper here. Despite creating a more transparent approach to healthcare pricing, medical bills remain a major concern for many Americans. Nearly three in ten worry about the cost of healthcare. The prospect of an unanticipated and unaffordable final bill looms large over their entire healthcare experience, exacerbated by the job losses and insurance changes that left many on unsteady financial ground during the pandemic. Patients aren’t only looking for greater certainty about what they’ll owe, they also want the payment experience to be easier. The pandemic created a new baseline in digital patient access and pulled healthcare closer to other service experiences, where digital and contactless payment methods are the norm. To ease patients’ concerns and meet consumer expectations, providers should focus on redefining payment operations through the eyes of the patient. Patients want to know about their medical costs upfront so they can prepare. Experian Health’s State of Patient Access 2.0 survey found that nine out of ten providers agree that this also increases the likelihood that bills will be paid. They want quick and convenient ways to pay and utilize digital apps with user-friendly interfaces. They don’t want a one-size-fits-all approach to their healthcare experience ­– and that includes the payment process. Personalized estimates, payment plans and proactive reminders can all help patients feel confident about their medical bills. The right tools exist to help providers create a great patient experience and reduce the amount of revenue lost to bad debt – it’s all a matter of integrating those tools into existing systems. Help patients plan for bills with transparent pricing According to a study by Pew Research, around half of nonretired adults feel the pandemic has made it harder for them to reach their long-term financial goals. Many patients are keeping a closer eye on household finances in the wake of COVID-19, so helping them to understand their bills from the onset is key. This can help providers enroll patients in the right payment plans, and will lead to smoother patient collections. Accurate, upfront estimates should be utilized to improve the patient payment experience. Patient Payment Estimates give patients a clear cost breakdown straight to their mobile, so they can plan accordingly for out-of-pocket payments. Providers that implement these solutions now will be better prepared as price transparency legislation continues to evolve and grow. Offer flexible payment methods for faster payments Accurate estimates are just the first step: next, providers should make it as easy as possible for patients to pay their bills. Healthcare has typically lagged behind other industries when it comes to quick and convenient digital payment options. However, the pandemic nudged consumers and providers alike to embrace alternate payment models for medical bills. Many patients want to continue using digital and contactless payment methods – including credit cards and mobile payment apps. With a service such as Patient Financial Advisor, providers can direct patients to an appropriate and flexible payment plan, as well as secure ways to pay, without the need for multiple patient calls. Create a personalized payment experience with third-party data and analytics These tools are effective because they enable personalized experiences for every patient. Some patients may prefer to pay in full before they come in for care, while others may need to pay in installments. Some may prefer to pay via a mobile app, while others may choose to pay in person with their credit card. Certain patients may prefer to receive statements and other communications via email, while others will want to speak to an advisor on the phone. A personalized approach not only creates a better patient experience but also increases patient payments and reduces providers’ cost to collect. Achieving this requires access to accurate and reliable third-party data that paint a fuller picture of an individual patient’s needs and preferences. With consumer data that draws on lifestyle, demographic, psychographic, behavioral and financial information, providers can tailor the payment experience to make it as accessible and frictionless as possible. Similarly, Collections Optimization Manager draws on multiple datasets to check coverage information, segment and prioritize patient accounts, and use staff resources efficiently to maximize revenue recovery. Heather Grover, VP of Product Management and Consulting – Patient Payments and Collections, says, “Clients seek processes that are not only tailored to each patient’s unique situation but one that helps automate their collections and payments workflow. Minimizing the use of resources in today’s environment – whether IT, operational or call center – helps lower the cost of collections while delivering a positive patient experience.” Find out more about how Experian Health’s suite of patient estimates and payment tools can help your organization offer a personalized and compassionate financial experience. Missed the other blogs in the series? Check them out: 4 data driven healthcare marketing strategies to re-engage patients after COVID-19 How 24/7 self-scheduling can improve the post-pandemic patient experience COVID-19 highlights an acute need for digital patient intake solutions Automated prior authorization: getting patients the approved care they need Getting a holistic picture of patients with social determinants of health 3 data-driven denial management strategies for faster claims processing

As the digital healthcare revolution takes hold, do assumptions about a generation gap still hold true? Do Millennials and Gen Z have different expectations of healthcare providers compared to Baby Boomers and Gen X? In today’s hyper-connected world, the differences are a matter of degree. We’re all Gen C now. Futurist Brian Solis coined the term “Gen C” in 2012 to describe the rise of the “connected consumer,” a generation of active participants in the digital-first economy. Recently, the term has come to be associated with everyone living through the age of COVID-19. This includes pandemic babies whose early months have been shaped by quarantines and virtual playdates, and consumers of all ages who have reimagined their lives through digital tools and services. Gen C transcends the usual generational divides. Experian Health’s State of Patient Access 2.0 survey shows that patients of all ages embraced self-service technology and virtual care during the pandemic. Younger groups may be in the majority, but demand for a consumer-centric digital patient experience crosses demographic lines. Forget Millennials and Gen Z – it’s Generation COVID that’s driving the healthcare revolution. In this article, we look at what healthcare providers need to know about the attitudes and expectations of Gen C consumers. How does healthcare need to adapt to successfully engage the connected generation? Gen C: it’s an attitude, not an age Think With Google describes Gen C as a “powerful new force in consumer culture… people who care deeply about creation, curation, connection, and community. It's not an age group; it's an attitude and mindset defined by key characteristics.” Understanding the Gen C mindset will give providers the competitive edge when it comes to patient engagement. What might that look like? Gen C is constantly connected. Nearly nine in ten have a social media profile, with two-thirds updating it daily. They’re accustomed to organizing their life through apps and digital technology. Younger Millennials and Gen Z have grown up with the digital world in the palm of their hand, and have come to expect quick, flexible, and convenient app-like access to real-life services. Gen C values authenticity and transparency. Recent political, economic, and environmental turbulence has created a group of consumers who choose brands and services according to their personal values. There is also a greater emphasis on convenience and price. Instant access to information means they may be more likely to question healthcare advice and compare services. And news reports of data breaches and corporate scandals mean providers may need to work harder to gain their trust. Gen C chooses brands that embrace the power of personalization and community. Gen C expects personalized patient experiences. However, they’re also looking for community. Health and wellness brands that facilitated connection through online groups grew in popularity during the pandemic, especially when people were unable to work out together. As influencer culture continues to evolve, more brands are inviting real consumers to act as brand advocates. This includes utilizing social media to give consumers an opportunity to engage directly in product development. Healthcare services that can offer ways for consumers to connect with like-minded communities will be particularly attractive to Gen C. How does Gen C feel about health? It’s no surprise that the pandemic has made consumers more health-conscious. Gen C takes a more holistic view of health than previous generations and is more likely to use wearables and fitness apps to track their health goals. They’re also more comfortable talking about previously taboo topics, such as mental health or sexual wellness. Digitally fluent consumers are also more comfortable seeking answers to health questions online. A study by Gartner found that 41% of consumers with a health issue would talk to friends or family, and 38% would search for information on their own, before contacting a physician. There’s an opportunity for providers to position themselves as the first and best resource for reliable, engaging and accessible health information. As Gen C’s influence grows, it pays for providers to invest in understanding their needs and expectations. How should providers adapt the healthcare experience for Gen C? Offer convenient, flexible and self-service access to care Flexibility, speed and convenience are woven into Gen C’s expectations of the healthcare experience. The State of Patient Access 2.0 survey found that around seven in ten consumers said they wanted to be able to schedule their own appointments online, and a similar number wanted the option to contact their provider through a patient portal. Gen C is less likely to use a desktop computer or make a phone call, so enabling mobile-friendly apps is key. Online self-scheduling allows patients to find and book available appointments using their mobile devices. Integrations with scheduling rules and up-to-the-minute calendar checks mean patients are only shown the most relevant provider booking information. It’s a closer match to their other consumer experiences, as opposed to long phone calls and wait times with a call center representative. Similarly, automated registration tools can simplify patient intake and give consumers the option to check their details on their mobile devices. Rather than filling out multiple paper forms that are labor-intensive and error-prone, patients can simply complete the process on their phone or tablet. And for the 39% of patients who worry they’ll catch an infection at their doctor’s office, being able to complete intake tasks without sharing clipboards and pens in the waiting room will be a huge relief. In a recent podcast interview with Beckers Hospital Review, Jason Considine, Chief Business Development Officer with Experian Health, said: “With COVID-19, digital tools and data-driven solutions introduced more streamlined processes into our healthcare system. The expectation is that they’ll remain. Providers must embrace this digital transformation. Invite patients to self-schedule online, leverage digital outreach tools, simplify the registration process, and provide a transparent cost of care with flexible payment options… We need to create a simple consumer experience that matches what patients have in other facets of their lives.” Use consumer data to offer personalized outreach and boost patient loyalty Understanding Gen C requires providers to rethink patient loyalty. In the past, patients might choose a physician and stick with them for much of their adult life. Now, they’re more likely to shop around. Research published just before the pandemic showed that 73% of consumers expect companies to understand their needs and expectations, and 62% expect those companies to adapt according to the consumer’s actions. Experian Health’s survey also showed that patients welcome proactive outreach by providers, though many providers fail to do so. Nearly half of providers said that inaccurate or incomplete data prevented this. Providers know that a personalized healthcare experience is good for their bottom line, but without reliable data about each patient’s needs, preferences, and lifestyle, delivering this is a challenge. Consumer healthcare marketing data can pull together reliable data sources to allow providers to communicate the right message in the right channel for different patient segments. For an even richer view of patients’ individual non-clinical needs, providers should consider including social determinants of health (SDOH) data. COVID-19 revealed gaps in healthcare providers’ capacity to leverage data to support economically and socially vulnerable groups. With this type of data, providers can personalize their outreach strategies in a way that truly supports individual patients and underserved communities. Make it easy to pay with upfront estimates, coverage clarity, and digital payment methods Household financial concerns were felt even more acutely over the last two years. Younger generations say they’re more likely to consider cost when it comes to making healthcare decisions, with almost 60% saying it’s now the main consideration. Gen C expects upfront, transparent cost estimates, with two-thirds of younger consumers saying they’re more likely to seek out medical care if they know the cost beforehand. The State of Patient Access 2.0 survey confirms that price transparency remains high on the list of patient demands. To this end, there has been a major regulatory push toward price transparency at the federal and state levels. Many providers are deploying transparent pricing strategies and payment estimate tools to make it easier for patients to navigate the costs of care. Demonstrating a commitment to price transparency can be a powerful marketing strategy to attract and retain loyal consumers – especially for those who are most affected by fluctuating employment and financial circumstances. Watch our interview with Dan Wiens, Product Director for Patient Estimates at Experian Health, in which he describes how price transparency and patient estimates will evolve in 2022. Patient payment estimates give patients clear, accessible, and easy-to-understand estimates before they come in for care. A cost breakdown is delivered straight to their mobile device, with the option to pay right away. In addition to payment estimates, Gen C is looking for payment plans and payment mechanisms to be available at their fingertips, anytime, anywhere. In a world where they can order food and pay household bills at the tap of a button, it can be frustrating to have to wait a month for a medical bill. In fact, 70% of consumers say healthcare is the industry that makes it hardest to pay. Providers that can offer a choice of simple payment methods, pre-and post-service, will be likely to attract more Gen C patients. An integrated solution such as Patient Financial Advisor can help these tech-savvy consumers see their estimated cost of care, and make payments right from their mobile device. For providers, the benefits of making it easier for patients to pay are clear. As demand for transparent and contactless payment methods continues to grow, investing in these digital innovations could be an effective route to recouping some of the financial shortfall experienced during the pandemic. Don’t forget – more healthcare staff are Gen C, too Digital transformation isn’t just a consumer issue. Many of the digital tools and services that enable providers to meet the needs of connected consumers will offer benefits at the organizational level too. Automation and advanced analytics lead to more efficient processes, better use of staff resources, fewer errors and more meaningful workflow insights. Time and money are saved, profits increase and staff enjoy a more satisfying working experience. Investing in incremental innovations on back-end systems is even more relevant, given that growing numbers of healthcare staff are Gen C themselves. Just like consumers, they are accustomed to using digital apps and tools to run their lives, and they’re looking for similar efficiencies while at work. Failure to provide staff with the tools they need to do their jobs in the digital age could lead to wasted time, revenue loss, and the adoption of less reliable and secure workarounds. With the right digital tools and systems, providers can equip staff to fulfill their roles safely and effectively -- attracting and retaining a high-performing workforce. Providers must open their digital front door to secure patient loyalty now and in the future The pandemic has cemented a cultural and practical shift in the way healthcare is delivered. Now that more patients have had a taste of a digital patient experience, they expect it to continue. Gen C is pushing the healthcare industry to catch up to convenient, connected, consumer-centric services that are the norm elsewhere. Providers that can engage with Gen C in their digital language now will attract more satisfied consumers over the long term. Contact us to find out how we can support your organization bring together all the digital tools at your disposal, to create a healthcare experience that’s in line with Gen C’s evolving expectations.