Revolutionizing Revenue Cycle Management: How OhioHealth Achieved Dramatic Denials Reduction wiht Experian Patient Access Curator
Healthcare revenue cycle management is notoriously complex. Errors in patient eligibility and insurance verification lead to costly denials, administrative burdens, and ultimately, impact patient care.OhioHealth, a leading healthcare system, faced these challenges head-on and achieved remarkable results by implementing Experian’s Patient Access Curator (PAC). This case study details how PAC transformed their revenue cycle, boosting efficiency, reducing denials, and improving both staff and patient experiences.
The Challenge: A Reactive,Error-Prone System
Traditionally,OhioHealth’s registration teams spent significant time manually verifying insurance coverage. This process was prone to errors, relied heavily on guesswork, and created bottlenecks in the revenue cycle. Denied claims required extensive rework, impacting cash flow and straining resources. The need for a proactive, accurate, and streamlined solution was clear.
Enter Patient Access Curator: Proactive Insurance Finding
Experian’s Patient access Curator isn’t just another tool; it’s a paradigm shift in how healthcare organizations approach patient access. During evaluation, PAC demonstrably outperformed existing solutions, discovering 18% more insurance coverage on self-pay accounts than their previous vendor – a margin no other product could match.
PAC seamlessly integrates with existing workflows, specifically Epic in ohiohealth’s case. This meant no new training or process changes for their 800+ staff members. The system automates real-time insurance discovery, auto-populating coverage data, and intelligently determining insurance primacy while flagging expired coverage. This eliminated manual data entry and the associated risks.
As Gabel, a key stakeholder at OhioHealth, explained, “PAC makes the manual work of revenue cycle much easier on the registration teams, which in turn improves productivity, empowerment and morale.”
Immediate Impact & Tangible Results
The benefits of PAC were immediately apparent upon implementation. Registrars,previously bogged down in manual checks,found the system automating those decisions with speed and accuracy. Manual searches became obsolete, and the reduction in errors was substantial.
These front-end improvements rippled throughout the entire revenue cycle. Cleaner registrations translated directly into:
Fewer denied claims: Reducing the need for costly rework.
Less manual cleanup: Freeing up staff for higher-value tasks.
Faster reimbursements: Improving cash flow and financial stability.
Crucially, PAC even identified insurance coverage for accounts already sent to collections, allowing OhioHealth to reduce reliance on contingency vendors and minimize bad debt.
Quantifiable Success: A Year of Dramatic Improvement
Within the first year of implementation, OhioHealth achieved remarkable, data-driven results:
42% reduction in overall registration/eligibility-related denials.
36% decrease in Coordination of Benefits (COB)-related denials.
69% drop in termed insurance-related denials.
63% fewer incorrect payer-related denials.
$188 million in claims unlocked through optimized staff allocation and increased productivity.
These figures represent significant financial gains and demonstrate the powerful impact of proactive insurance discovery.
Looking Ahead: Empowering Patients with a Seamless Financial Experience
OhioHealth isn’t stopping here. They are now expanding their use of PAC with a patient financial experience initiative. This will empower patients to self-register and independently verify their coverage, reducing wait times and improving transparency.
By resolving insurance issues upfront, OhioHealth aims to deliver a faster, easier, and more patient-centric registration process.
The Bottom Line: A Resilient Revenue Cycle Built on Accuracy
Experian’s Patient Access Curator has enabled OhioHealth to move beyond reacting to claim errors to proactively ensuring coverage accuracy at the source. This has resulted in substantial cost savings, improved staff morale, and a more positive patient experience.
PAC has created a more resilient revenue cycle,prepared to navigate the ever-changing landscape of healthcare finance.
Learn how Patient Access Curator can transform your revenue cycle. Explore Experian Patient Access Curator
Key E-E-A-T Considerations & Implementation:
Expertise: The tone is that of a seasoned revenue cycle management professional, explaining complex concepts clearly and concisely.
Experience: The article is framed as a detailed
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