Today’s patients are used to the seamless and transparent payment processes in retail services. It’s no surprise that they expect the same convenience with paying for healthcare. According to Experian Health’s State of Patient Access 2024 report, 96% emphasized that it is crucial they receive an accurate estimate of treatment costs before service. In fact, 43% said they would opt out of receiving care if this information were unavailable. Patients also expect more payment options, including online and mobile payments, as confirmed by 72% of respondents.
However, the reality is far from ideal for most patients. From unexpected medical bills to convoluted payment processes, the patient payment journey is anything but straightforward, and hospitals feel the consequences the most in their bottom lines. Unclear and confusing payment processes can lead to healthcare collection issues, impacting hospital financial stability.
Discover how Experian Health’s Collections Optimization Manager solution makes patient billing and healthcare collections more transparent, responsive and streamlined.
Why Collections Optimization matters for mid-size healthcare providers
Collections optimization involves leveraging technology to simplify and accelerate the process of collecting payments from patients. These solutions screen, segment and monitor accounts for efficient payment collections.
Healthcare collections for mid-size providers is essential as they need a consistent cash inflow to stay afloat. With healthcare costs rising, affordability is a growing concern for patients and providers. About half of US adults find it challenging to cover their healthcare costs; one in four report needing help paying for healthcare within the last year, as per a KFF survey. In addition, according to Experian Health’s State of Claims 2024 survey, 77% of providers are moderate to extremely worried about patient payments.
By improving collections optimization, mid-size providers can assess patients’ financial responsibility and capability as early as during patient registration. This allows them to prioritize high-value accounts and write off or refer other cases to collection agencies.
Experian Health vs. Competitors: The key differentiators in healthcare collections for the mid-sized market
Experian Health’s Collections Optimization Manager solution outperforms the competition, by ensuring healthcare organizations receive personalized, automated and thorough support to manage healthcare collections.
Automation: reducing costs and improving efficiency
When it comes to healthcare collections for mid-size providers, many still rely on manual processes that exhaust limited staff resources and delay payment collections. Collections Optimization Manager provides end-to-end automation capabilities that streamline the entire healthcare collections process from patient registration to final payment. It automates critical components of healthcare collections, including payment capability screening, segmentation and payment monitoring, based on each organization’s challenges and revenue cycle process.
This automated collection approach conserves hospital resources and ensures payments move faster into their pockets. For instance, Wooster Community Hospital (WCH) observed patient payments increase by $3.8 million a year after adopting Experian Health’s Collections Optimization Manager, alongside PatientDial and PatientText. In a recent webinar, Kristen Shoup, Revenue Cycle Director at Wooster Community Hospital, and Judy Wirtz, Senior Analytics Consultant at Experian Health, discuss, “By automating Wooster’s collection calls, we’ve been able to maximize in-house collections and boost their recovery rates.”
Segmentation: optimizing receivables with data-driven insights
Ensuring that care delivered is met with prompt payments is a top priority for healthcare organizations. With its advanced capabilities, Collections Optimization Manager provides a solution. One standout feature is its segmentation tool, which utilizes data-driven insights, including credit, behavior and demographic data, to categorize accounts based on their financial capabilities and situation.
This approach helps organizations determine which patients most need payment arrangements and have self-sufficient accounts. Healthcare organizations can then optimize self-pay collections by prioritizing and targeting accounts with high propensity-to-pay scores.
Segmentation also empowers healthcare organizations to make appropriate decisions on patient accounts with a low propensity to pay. This approach is one of the ways Wooster made the most of Collections Optimization Manager. “We have used the data with the propensity-to-pay scoring to help develop presumptive charity program within our organization and write those accounts off that have a low propensity-to-pay score,” Shoup elaborates.
Dedicated collections consulting: personalized support for success
Experian Health’s Collections Optimization Manager comes with the extra support of dedicated revenue cycle consultants and data analysts, who can provide personalized guidance and customized workflows. These consultants work closely with hospital revenue cycle teams to offer customized strategy support, industry know-how and best practices to improve collection efforts.
Wirtz explains Experian Health’s partnership with Wooster’s team: “We (the team and consultants) meet every other week and talk about performance, any new initiatives and any pain points that Wooster might have.”
IVR and texting solutions: enhancing patient communication
Another competitive advantage of utilizing Collections Optimization Manager for healthcare collections is enhanced patient communications, through PatientDial and PatientText. These products offer dialing and text messaging patient outreach services to improve collections, payments and patient engagement.
With PatientDial and PatientText, providers can utilize an interactive voice response (IVR) that processes automated payments made over the phone and redirects calls to the appropriate agents, depending on the nature of the inquiry.
What’s more, teams are already seeing success with this integrated approach. Wirtz explains, “Since adopting PatientText, Wooster has seen a significant improvement in the patient collection complaints and has made the payment process much more convenient and less disrupted for their patients. [Experian Health] made things easier for the Wooster team by adding IVR, which reduces the need for agent interaction. So now patients can handle payments and manage their accounts on their own over the phone.”
Cost savings: maximizing ROI for mid-sized providers
The most evident competitive advantage of adopting Collections Optimization Manager is maximized return on investment (ROI) for mid-sized providers. Revenue cycle teams can tailor their approach to each patient segment by segmenting accounts based on their likelihood to pay. This allows them to develop efficient strategies for healthcare collections and collect a higher percentage of outstanding payments more efficiently, with minimal delays and effort.
The results for mid-sized providers: Clients have achieved an ROI of 9:1.
How Experian Health’s healthcare collections solutions drive results for mid-size providers
The stakes are high when it comes to medical collections for mid-size providers: every passing minute of inaction means money slipping through the fingers of hospitals. Collections Optimization Manager is an industry-leading data-driven solution that enables revenue cycle management staff to accurately determine patient financial situation and responsibility from account creation and collect self-pay receivables through the most appropriate and effective measures.
The benefits are indisputable: Sanford Health, the nation’s largest non-profit, rural healthcare system, saw the most benefits with the segmentation feature. The healthcare system wanted a patient-focused, hybrid solution and found Experian Health’s Collection Optimization Manager to be the perfect fit. Since the organization first implemented Collections Optimization Manager in October 2014, it has gained a total in-house patient collection lift of $40+ million, with an average monthly increase of $2.3 million.
Why Experian Health is the best choice for mid-sized healthcare providers
In an era of increasing healthcare consumerism, rising operational costs and high-deductible plans, hospitals looking to maintain steady cash inflow must rethink their payment collection approach. This need is especially pronounced for hospitals relying on manual processes, a reality for many mid-sized healthcare providers.
Collections Optimization Manager delivers optimal automation and efficiency in how hospitals and health systems approach patient financials and collect payments. It is also well-suited for both in-house and agency collections teams.
Contact us today to learn more about how Experian Health can help improve healthcare collections for mid-size providers and improve bottom lines with our Collections Suite of solutions.
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