Four strategies to optimize patient collections

Experian Health products referenced in this blog post:

Healthcare may be historically more recession-resistant that other industries, but the COVID-19 pandemic has left many providers hurting financially, as many patients struggle to pay their bills. Patient collections were already a challenge, with declining Medicaid coverage and rising co-pay obligations putting patients on the hook for more of their healthcare expenses. Now, with millions of Americans out of work and missing out on employer-sponsored insurance, providers are being forced to adapt their collections processes to fit this unstable insurance landscape, or risk losing more dollars to bad debt.

Four key strategies can help providers seal the cracks in patient collections and stem the surge in uncompensated care. With compassionate processes that treat each patient as an individual, providers can use data and automation for more efficient healthcare charity screening, find missing coverage and identify both propensity to pay and the best financial pathway to minimize the chances of bills going unpaid.

1. Screen for charity eligibility early and often

Nearly 4 in 10 unemployed Americans have been without work for more than 27 weeks – the most since November 2013. As unemployment persists and benefits dwindle for many, more patients may be eligible for charitable support to cover their healthcare costs. Running presumptive healthcare charity screening as part of the collections workflow can help providers identify those who should be getting extra support.

Patient Financial Clearance runs automated checks when a patient registers, so individuals can be automatically enrolled as soon as eligibility is confirmed. Checks are repeated throughout the patient journey, should their financial situation changes.

Caye Mauney, Patient Access Director for Palo Pinto General Hospital, says the automated checks can confirm eligibility within just three seconds. This saves a huge amount of time for her team, while giving patients financial clarity without worrying waits: “All the information we need is now at our fingertips. The patient no longer needs to bring in check stubs or go back to a former employer to ask for information. It’s been a game changer.”

2. Find forgotten coverage quickly 

Automation can help providers cut uncompensated care by finding missing and forgotten coverage, even when patient case mix and payer rules are constantly changing. Healthcare organizations that quickly uncover previously unidentified coverage are often are paid sooner and avoid the collections challenges of self-pay receivables.

Experian Health’s Coverage Discovery uses best practices around search, historical information, multiple proprietary data sources and demographic validation to find previously unknown coverage. It continuously scans for insurance coverage to maximize reimbursements and minimize accounts sent to collections and to charity.

Learn from Banner Health how Coverage Discovery has helped the organization find 30+% unidentified coverage earlier in the revenue cycle.

Register for the webinar here.

3. Improve the collections experience with compassionate billing

Speedy coverage checks are just one way to give patients peace of mind when it comes to medical expenses. The collections process is often opaque and intimidating, hitting patients when they’re already stressed and vulnerable. The more compassion that can be built in, the better the patient financial experience will be. Unpaid bills go down, while patient loyalty goes up.

Transparent pricing, data-driven payment plans, personalized communications, and easy ways to pay all contribute to a positive patient financial experience. A good place to start is with Collections Optimization Manager, which allows providers to segment, support and monitor patients throughout the entire collections cycle. By connecting to a host of other patient-facing tools, this helps members feel taken care of from start to finish.

4. Use data to put patients on best payment pathway

None of these strategies will work without reliable, accurate data. Healthcare organizations traditionally rely on demographic and behavioral datasets, but this leaves gaps in how much is known about patients’ financial situations. Incorporating credit data can add a layer of valuable insights about a patient’s propensity to pay, so collections resources can be directed to the appropriate accounts. If you know a patient has a missed mortgage payment or delinquent loans, you can help them find alternative coverage and redirect them to a better payment pathway.

Experian Health combines demographic, behavioral and credit data so you can help your members navigate their health expenses with confidence. The result? Better financial health for both your members and your organization.

Find out more about how to optimize patient collections, whatever 2021 has in store, in our recent eBook, Recession-proof your revenue cycle. 

Download now.

The post Four strategies to optimize patient collections appeared first on Healthcare Blog.

Success at a glance: finding unidentified coverage

It is estimated that 30-50% of denied claims occur on the front end during the patient access process, namely during registration, authorization and eligibility. Unfortunately, manual patient intake processes contribute to these denials, and ultimately, the bottom line, staff productivity and the patient experience take the hit.

Banner Health chose to automate its patient access processes with eCare NEXT from Experian Health. The solution, which integrates directly with Banner Health’s acute and ambulatory electronic health records (EHRs), automates the organization’s preregistration workflow, including medical necessity and financial clearance. This improves registration accuracy, provides more accurate patient estimates and reduces the number of denials on the front end.

Banner Health has benefited by incorporating a mix of Experian Health products that integrate directly and collaborate with other technologies and workflows already in place:

  • Decrease in eligibility errors. With eCare NEXT, initial denials due to eligibility errors have been reduced by $30M in the first quarter alone since going live with Experian Health.
  • Significant cost savings. With more accurate estimates, Banner Health has seen significant cost savings on the front end from more efficient coverage discovery. The system is consistently finding 30+% unique or new coverage in the patient access workflow.
  • Improved staff engagement and satisfaction. Automation has greatly reduced manual inputs, enabling staff to focus more on the patient rather than systems and logins required for patient intake.

Our partnership with Experian Health helps Banner Health’s revenue cycle team deliver on its mission of “getting it right, at the right time, every time.” 
— Becky Peters, Executive Director of Patient Access Services, Banner Health

Want to learn more about Banner Health’s success in finding unidentified coverage earlier in the revenue cycle? Sign up for the January 21 webinar below, where attendees will gain insight into the organization’s proven workflow and processes.

Register here.

The post Success at a glance: finding unidentified coverage appeared first on Healthcare Blog.

Finding unidentified coverage without a Social Security Number (SSN)

Finding previously unidentified insurance coverage can feel a little like a game of hide and seek. Patients may not always be aware of their insurance or eligibility for Medicare and Medicaid, and, in an effort to both improve the patient financial experience and simultaneously improve collections, providers are often tasked with finding this information on the spot. Historically, providers have used demographic information like Social Security Numbers (SSN) as a means to verify patient identities and locate this information, but that tactic is increasingly unreliable as it is possible for more than one person to use the same SSN and SSNs are a lucrative route to stealing someone’s identity.

With this in mind, many health plans are no longer using SSNs as an identifying number for insurance coverage. In fact, the Centers for Medicare & Medicaid Services recently removed SSN-based Health Insurance Claim Numbers (HICNs) from Medicare cards and are now using Medicare Beneficiary Identifiers (MBIs) for Medicare transactions like billing, eligibility status, and claim status.

The latest health plans to remove this piece of demographic information is Health Net Medi-Cal and Health Net National. Effective September 25, 2020, the search options for eligibility for this plan have changed. Providers will ONLY be able to find and verify coverage with a subscriber ID.

“Providers are often tasked with finding this information on the spot.”

While Health Net Medi-Cal and Health Net National are the latest health plans to do away with demographic searches, it’s certainly not a surprising trend and more will likely follow suit.

Bridging the gap with historical data

Uncovering previously unidentified coverage is critical for providers as it helps to eliminate costly self-pay situations, bad debt write-offs and unwarranted charity designations. And, without the proper insurance information, patients also risk delayed access to care and other financial hardships.

With demographic searches on the decline, providers will need a more efficient and reliable way to search for coverage. As a data-driven company with a historical repository of claims data, Experian Health is uniquely positioned to help providers search for coverage.

Combining search best practices, multiple proprietary databases and historical information, Experian Health’s Coverage Discovery locates patients’ billable commercial insurances that were unknown or forgotten, and combs through Medicare and Medicaid coverage. This flags accounts that may have been destined as a write-off or charity and maximizes reimbursement revenue by identifying primary, secondary and tertiary coverage. Not only do fewer accounts go to bad-debt collections, but providers can automate the self-pay scrubbing process.

A tool like Coverage Discovery is even more beneficial for providers during COVID-19, where limitations of face-to-face contact make it more difficult to complete the usual coverage checks. Coverage Discovery empowers providers to facilitate coverage checks remotely, avoiding delayed reimbursements during a time when revenue streams are already feeling pressure.

“As a data-driven company with a historical repository of claims data, Experian Health is uniquely positioned to help providers search for coverage.”

Want to learn more? Contact us to see how Coverage Discovery can help find previously unidentified coverage and reduce bad debt.

The post Finding unidentified coverage without a Social Security Number (SSN) appeared first on Healthcare Blog.

Seniors navigating healthcare technology in a post-COVID world

Products referenced in this article:

With just a few clicks, patients can book appointments, speak to their doctor, access billing information and pay for care, all without leaving their homes. Online health services have been a lifesaver for many during the pandemic, and the reliance on digital tools has sky-rocketed over the last few months. But for some older consumers who may be less comfortable using digital devices, this shift towards “healthcare from home” feels daunting and isolating.

Many seniors are not immersed in the digital culture and navigate life just fine without a touchscreen. The sudden shift in healthcare delivery channels has demanded many to venture into unfamiliar technology in a rushed and urgent manner. Others face barriers related to things like dementia, hearing loss and vision loss.

Closing the digital divide

Whatever their age, those left out of the digital loop face a higher risk of missed appointments, delayed care and anxiety about how to get tests and treatment. Providers will want to ensure that all of their digital offerings are designed to help patients of every age access care in a way that works for them. That means creating a consumer experience with pathways and channels to suit different patient needs and expectations, including “analog” options for those who aren’t inclined to learn new technologies.

4 ways to make digital health technology more senior-friendly

1. Use data to determine what’s working and what’s not

The starting point for providers who want to improve seniors’ digital engagement is to understand how they’re actually using it (or not) right now. Non-clinical data can give insights on technology engagement, lifestyle and socioeconomic circumstances across all ages in a patient population. When providers know what patients are looking for, and where the gaps are, they can tailor their services to meet their patients’ needs.

For example, let’s say a proportion of an organization’s older members have smartphones or tablets, but aren’t using them to access their patient portals. It’s likely they have the skills so but may not be aware of the service. This can be solved with a simple omnichannel outreach campaign to provide step-by-step instructions explaining how to get started.

One way for providers to capture useful data is with “Z codes” — the ICD-10-CM codes included in categories Z55-Z65. These identify non-medical factors that may influence a patient’s health status. Utilizing Z codes will enable better tracking of seniors’ needs and identify solutions to improve their health and wellbeing.

Providers can also leverage data to better understand seniors’ activity in the continuum of care. Are older patients continually presenting for care at a facility that is out of network? A tool like MemberMatch can deliver these insights in real time, alerting care teams as early as possible so that they can rally around active episodes of care proactively and efficiently. This helps risk-bearing organizations optimize the quality and cost of member activity in the continuum of care, leading to better outcomes for patients and a better bottom line for organizations responsible for their health.

2. Give patients choices about how they access services

Adoption of healthcare technology is increasing among older adults: 76% of over 50 say they welcome services to help them “age in place”, or live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level. At CareMount Medical, 27% of primary care appointments made using Experian Health’s online scheduling tool are initiated by those aged 60 and over. The demand is there; support should follow.

That said, an omnichannel approach is still important. Given a choice, more than half of people aged 50 and over prefer their health be managed by a mix of medical professionals and technology. This means giving patients the option to easily schedule appointments by phone. Automated outreach and integration, combined with practice management systems, will ultimately make patient scheduling easier.

3. Make virtual care easier to use

More than half of seniors cancelled or delayed appointments due to COVID-19. Despite the promise of safety measures, many are hesitant to return. Virtual care may be the answer.

Providers are quick to learn that telehealth is not a panacea, in particular for the senior population. As some patients may not have the technology and skills to access telehealth, providers may want to consider a hybrid “facilitated telehealth” model where medical professionals visit patients’ homes to help them get set up for telehealth visits.

4. Create a smoother patient financial experience

As older patients become newly eligible for Medicare, many are unclear about their coverage status. To take the burden off the patient, providers should consider a tool such as Coverage Discovery, which allows staff to find MBI numbers quickly. This often proves helpful, particularly for new Medicare beneficiaries who may not have received their MBI card yet.

A way to ease the stress of payments is to offer more transparent pricing so patients know what to expect as they start their healthcare journey. Experian Health’s Patient Financial Advisor gives a breakdown of their bill and payment options, helping them feel financially confident and more in control of their ability to pay – resulting in fewer collections issues.

As older patients become more accustomed to paying for other everyday items through their smartphones or laptops, online patient payment solutions will become less foreign and more convenient, allowing them to manage medical payments in a time and place that suits them.

It’s never been more important to help older patients stay connected, access care and feel supported during their healthcare journey. Contact us to explore how Experian Health’s solutions can help you close the digital divide.

The post Seniors navigating healthcare technology in a post-COVID world appeared first on Healthcare Blog.

Improving patient intake during COVID-19 starts with patient experience upgrades

Despite the majority of elective procedures
being up and running again, patients are still keeping their distance. Nearly
half of Americans
say they or a family member have delayed care since the
beginning of the pandemic, while visits to the emergency room and calls to 911
have dropped
significantly
. Patients are avoiding care, but it’s not for the reason
you’d expect.

Beyond obvious worries about catching and
spreading the virus, a second concern is becoming apparent: patients are
fearful of the potential cost of medical care. With so many furloughed, laid
off or losing their insurance coverage, medical care has become unaffordable for millions of Americans. It’s especially tough for
those who fall into the coverage
gap
, where their income is too high to grant access to Medicaid coverage,
but too low to be caught by the ACA safety net.

If patients continue to delay care, it’s
only a matter of time before their symptoms worsen, leading to more complex and
expensive treatment or even risking their lives. For the hospitals and health
systems with revenue levels at a record low, encouraging patients to return for
routine care is a matter for their own financial survival too.

The answer lies in making sure patients feel safe and comfortable both when they come in for care, and when they look at their financial responsibilities.

5 ways to ease the return to routine care

1. Reassure patients about safety measures before and during their visit

Patients are understandably anxious about
what their visit is going to be like. Will they have their temperature taken?
What should they do if they have symptoms of the virus? Will seating areas be
spaced out and sanitized? Pre-visit communications and proactive
information on arrival will help them feel comfortable and eliminate the shock
factor of seeing more stringent infection control measures.

2. Minimize unnecessary contact by shifting patient intake online

From online scheduling and
pre-registration to telehealth and contactless payment, there are many ways to
keep face-to-face interactions to a minimum. Not only will this help reduce the
spread of the virus, it’ll make the whole patient experience more convenient
for patients. Exploring a virtual and automated patient intake experience can also free up staff to work on other tasks, thus also protecting the
organization’s bottom line through efficiency savings.

3. Encourage patients back to care with automated outreach campaigns

With so much uncertainty at the moment,
patients may be unsure if it’s even appropriate to come in for routine care.
Use automated outreach to prompt them to
book appointments and schedule follow up care. A digital scheduling platform
can help you set up text-based outreach campaigns, to reassure patients that
it’s safe (and essential!) to come in for any overdue care – without placing
any undue burden on your call center.

4. Provide price transparency before and at the point of service

With healthcare experts pointing to financial
worries as a major barrier to care, anything providers can do to improve the
patient financial experience is an advantage. Price transparency is the first step.
When patients have clear and accessible payment estimates upfront, they can
plan accordingly and/or seek financial assistance as quickly as possible,
reducing the risk of non-payment.

5. Screen for charity care eligibility with faster automated checks

Once those payment estimates have been
generated, the next step is to confirm whether the patient is eligible for financial support, in the event that they’re unable to cover their bill. Checking eligibility
for charity assistance is a time-suck for patient collections teams, but with
access to the right datasets, it’s a perfect candidate for automation.

These steps become even more urgent as
providers face the prospect of a ‘twindemic’ – or a surge in COVID-19 cases
colliding with flu season.
By avoiding delays to care, patients can avoid the need for more serious and
expensive treatment further down the line, when hospitals are likely to be
under even greater pressures.

Contact us to find out more about how our
data-driven, automated patient intake
solutions
can help make your patients feel as safe and
comfortable as possible, both physically and financially.

The post Improving patient intake during COVID-19 starts with patient experience upgrades appeared first on Healthcare Blog.