Experian Health’s State of Claims 2022 report reveals a worrying trend in the increasing rate of denied claims in healthcare. Three-quarters of the 200 health professionals surveyed said that claims are denied 5%–15% of the time. Nearly a third see claims denied 10–15% of the time. Denials at this scale represent billions of dollars in lost or delayed reimbursements plus extra overhead to rework and resubmit claims. It’s no wonder that reducing claim denial reasons remains a top concern for revenue cycle decision-makers. With billions of dollars at stake, reducing health insurance claim denia ..read more

Claim denials are costly to correct and resubmit. They impede revenue flow, slow down patient care delivery, contribute to poor patient experience and satisfaction, increase administrative workload and take up limited staff time and resources. While they’re avoidable, Experian Health’s State of Claims 2022 report shows that 30% of respondents say denials are increasing between 10-15% year over year, which costs health systems billions of dollars. Moreover, rebilling payers often proves fruitless. Despite taking up resources and staff time and productivity and slowing down healthcare delivery ..read more

According to Experian Health’s State of Patient Access Survey 2024, eight in ten healthcare providers plan to invest in patient access improvements soon. As they weigh up the pros and cons of different solutions, many will focus on two key areas: making scheduling and registration easier for patients, and streamlining financial processes to boost their profitability. This blog post examines how automated patient access solutions can help providers meet patient expectations and operational demands. Survey snapshot: what do patients want? Experian Health’s annual State of Patient Access surveys ..read more

Once hesitant, the healthcare industry is slowly embracing artificial intelligence (AI)’s potential. Healthcare stakeholders, particularly those in revenue cycle management, are now interested in exploring AI-driven technology solutions to tackle daunting administrative tasks. According to data highlighted by the Journal of AHIMA, two-thirds of health systems are adopting AI to support revenue cycle processes. AI offers solutions that address the complexities of medical billing, insurance claims, and patient payments and enhance hospitals’ financial health. The potential savings from AI adopt ..read more

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. While the Centers for Medicare & Medicaid Services (CMS) found that ..read more

“We ran a pilot across 10-15 service lines, and the team was able to schedule without any training. It makes it extremely easy to work in different service lines that you’re unfamiliar with.” — Justin Baur, Manager of Patient Access and Referral Management at IU Health Challenge Indiana University Health (IU Health) is the largest network of physicians in Indiana, with over 36,000 team members across five patient regions and 16 partner hospitals. IU Health plans to launch the Unified Medical Group in 2025, combining its five patient regions. In preparation for this move, the health system sou ..read more

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 pro ..read more

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 ..read more

In healthcare revenue cycle management (RCM), the mantra is clear: maximize revenue and minimize costs. It’s more complex in practice, requiring RCM leaders to anticipate and adapt to whatever’s around the corner. Following the latest revenue cycle management trends is vital, as economic turbulence and labor shortages demand flexibility and resilience. Competition from new players and changing consumer expectations call for constant updates to the latest technology. And currently, as electoral news cycles heat up ahead of the general election, attention is turning to potential policy changes ..read more

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 ..read more