Case Study: Emory Healthcare recovers $21.3 million in underpayments with Experian Health

Uncovering contractual details helps collect revenue left on the table

Emory Healthcare, through Emory Clinic, faced the challenge of identifying underpayments across a very large claims volume while also improving patient collections and reducing bad debt as self-pay and high-deductible plan patients increased. The organization worked with Experian Health to add automation for contract management, patient responsibility estimation, eligibility and benefits verification, and financial assistance screening.

Using Experian Health’s Contract Manager, Patient Responsibility Pricer, Eligibility and Benefits Verification, and Financial Assistance Screening, Emory Healthcare was able to recover contractually allowed amounts, generate more accurate patient estimates, and streamline financial assistance workflows. The results included $21.3 million in underpayments recovered over 8 years, a 47% increase in financial counseling collections, $5 million in annual patient prepayments, and a reduction in patient bad debt from 3.5% to 1.1% of total charges.

Emory Healthcare

Taylor Williams

Director, Patient Financial Services