How improved insurance eligibility verification drives claims engines
Experian Health | Healthcare Management Blog
by Kelly Nguyen
23h ago
Because so many healthcare claim denials originate in the front end of the revenue cycle, providers should focus on improving insurance eligibility verification at the early stages of the patient journey. Verifying coverage earlier in the billing process with automated eligibility verification software increases the chance of submitting clean claims the first time and protecting future revenue. As coverage and benefits become more challenging for patients to navigate, prioritizing eligibility could also hold the key to better patient-provider relationships. Given the complexity of the healthc ..read more
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Q&A: What can providers do as millions lose Medicaid coverage?
Experian Health | Healthcare Management Blog
by Kelly Nguyen
1w ago
On April 1, 2023, millions of Medicaid recipients are set to lose coverage as the U.S. government’s COVID-19 public health emergency (PHE) expires. The Kaiser Family Foundation estimates that 5.3 to 14.2 million people will lose Medicaid coverage as the continuous enrollment provision of the PHE ends. Of this group, 6.8 million may be eligible to re-apply for Medicaid, but in the immediate term, it falls to patients and providers to sort through coverage questions, navigate charity and Medicaid eligibility, and keep bills out of collections. Mindy Pankoke, Senior Product Manager at Experian H ..read more
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How Schneck Medical Center prevents claim denials with AI Advantage™
Experian Health | Healthcare Management Blog
by Kelly Nguyen
1w ago
“The challenge we sought to overcome by leveraging AI Advantage at our organization was just gaining more insight into how denials originate and what actions we can take to prevent those from happening.” — Skylar Earley, Director of Patient Financial Services Challenge Starting as a 17-bed hospital more than 100 years ago, Schneck Medical Center now serves four counties in Indiana, with a staff of more than 1,000 employees, 125 volunteers and nearly 200 physicians. The organization’s vision is to deliver excellence, lead transformation and advance health, underpinned by a patient-first philos ..read more
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Reduce healthcare staffing challenges with patient self-scheduling solutions
Experian Health | Healthcare Management Blog
by Kelly Nguyen
2w ago
Staffing shortages continue to plague the healthcare industry, creating challenges for both healthcare providers and patients seeking access to care. In a 2022 CVS Health-Harris Poll National Health Project survey, 51% of 2,023 U.S. adults surveyed said they had been directly affected by healthcare staffing shortages. Among this group, 45% had trouble scheduling appointments, more than a third said their doctor was operating on reduced hours, and a quarter had treatments or surgeries delayed. Digital self-scheduling solutions help patients access care even when appointments are in limited sup ..read more
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Medicaid continuous enrollment is ending: how can providers prepare?
Experian Health | Healthcare Management Blog
by Kelly Nguyen
3w ago
Medicaid continuous enrollment will come to an end on March 31, 2023, as the temporary provisions are decoupled from the COVID-19 public health emergency. The federal government introduced the protections to ensure individuals did not lose coverage during the pandemic, leading to record enrollment levels. But as states prepare to resume routine renewals, up to 15 million people could end up without adequate insurance. Coverage gaps could disrupt access to health services and increase the risk of uncompensated care for providers. With Medicaid continuous enrollment coming to an end, how can pr ..read more
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Case study: How Stanford Health Care optimized patient collections to maximize recovery
Experian Health | Healthcare Management Blog
by Kelly Nguyen
1M ago
“With rising patient costs, there has been a need to increase engagement and keep costs low, while utilizing our resources wisely. Collections Optimization Manager is doing that for us, saving time and resources.” — Kristine Grajo, Director of the Self-Pay Management Office at Stanford Health Care Challenge Stanford Health Care is a level-1 trauma center operating between San Francisco and San Jose. In pursuit of its mission to heal humanity through science and compassion, it delivers clinical innovation across inpatient services, specialty health centers, physician offices, virtual care offe ..read more
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AI and machine learning for healthcare: What your organization needs to know
Experian Health | Healthcare Management Blog
by Kelly Nguyen
1M ago
Healthcare is undergoing a digital revolution driven by artificial intelligence (AI) and machine learning (ML) technology. While some organizations have been slow to adapt, others incorporated new solutions that have helped their organization identify patterns, reduce claim denials, and more. This infographic breaks down common phrases related to artificial intelligence and machine learning so that healthcare organizations can understand what they mean and how they’re utilized. Introducing: AI Advantage Experian Health is the top-performing claims management vendor, according to the 2023 Best ..read more
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How online payment software can improve patient experiences
Experian Health | Healthcare Management Blog
by Kelly Nguyen
1M ago
Digital tools are gradually helping to modernize healthcare, but there are still many gaps to fill when it comes to meeting critical needs. Outdated billing, payment and pricing models continue to be a hindrance for healthcare providers and patients. In an article for Chief Healthcare Executive, Tom Cox, President of Experian Health, made the case for using digital tools and online payment software to help patients better understand, manage, and live up to their financial responsibilities. “At a hefty $140 billion price tag, medical debt in the United States is a growing crisis,” Cox wrote ..read more
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Case study: How UCSDH improved collections and reduced bad debt
Experian Health | Healthcare Management Blog
by Kelly Nguyen
1M ago
“We serve our patients well when we can spend time explaining their bills, what’s been covered by their insurer and what payment options they have, so they feel confident in what is owed and why.” System Director of Patient Revenue Cycle at University of California San Diego Health (UCSDH) Challenge University of California San Diego Health (UCSDH) is one of the top health systems in the United States, ranked number one in San Diego by US News and World Report. With more than 9,000 employees, it generates over $2 billion in net patient revenue each year. Patient collections are managed ..read more
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Prevent claim denials with AI and automation
Experian Health | Healthcare Management Blog
by Kelly Nguyen
1M ago
Experian Health is the top-performing claims management vendor, according to the 2023 Best in KLAS: Software and Professional Services report. Experian Health’s ClaimSource® solution, an automated, scalable claims management system designed to prevent claim denials, ranked number one in the Claims Management and Clearinghouse category. Tom Cox, President of Experian Health, said, “We’re honored to receive this award. Our goal is to simplify the administrative aspects of care by addressing healthcare’s biggest business challenges using the power of Experian’s data, analytics and technology. By ..read more
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