Case Study: Baylor College of Medicine achieves higher reimbursements and better patient collections with Experian Health

Real-time contract analysis improves reimbursements now and later

Baylor College of Medicine, a Houston-based academic faculty practice plan with more than 1,200 physicians, needed a better way to manage payer contract performance across 50+ managed care contracts and 500,000+ annual claims. Manual underpayment analysis was labor-intensive and inconsistent, and the organization also struggled to estimate patient responsibility accurately at the time of service. Experian Health helped Baylor address these issues with Contract Manager, Contract Analysis, and Patient Responsibility Pricer.

Experian Health implemented contract compliance and analysis tools to verify contractual allowed amounts, identify underpayments, model proposed contract terms, and improve patient liability estimates. As a result, Baylor recovered $4.2 million in additional revenue, corrected systematic payment errors, strengthened its negotiating position with payers, and increased collections at the time of service through more accurate patient estimates.

Baylor College of Medicine

Richard Allison

Director of Baylor MedCare