“Patient Access Curator gave us data visibility we never had with our previous provider.”
Joyce Predmore, Director of Patient System Access and Financial Authorization, Columbus Regional Health
Challenge: Vendor outage caused registration workflow issues
CRH registration teams worked hard to keep patient intake moving, but their workflows lacked consistency. Payer selection was done manually, making it difficult to see why denials were occurring and take steps to prevent them. When a vendor outage knocked its automated eligibility verification tool out of service, leadership saw an opportunity to address these long-standing issues and overhaul the organization’s upstream processes.
CRH needed an immediate solution to reduce registrar errors and guesswork that would lead to more denials. By rethinking how initial decisions were made, the organization could standardize workflows and provide registrars with more reliable data to support decision making. This would prevent benefits eligibility and coordination errors from reaching claims and billing and lay the foundation for long-term improvements in revenue cycle performance.
Solution: Improve front-end accuracy with AI
CRH introduced Patient Access Curator™ (PAC) to get eligibility workflows back on track with more accurate initial data. This solution uses artificial intelligence (AI) and machine learning to automatically find and correct patient data in real time, covering eligibility, coverage discovery, benefits coordination, Medicare beneficiary identifiers, and patient demographics, all within a single platform.
Coverage checks that were previously performed manually have now been moved to an automated workflow. Patient Access Curator’s AI intelligence layer automates eligibility and coverage verification, and only flags cases that require review. Registrars, armed with more powerful tools, can now focus on exceptions, rather than reviewing each account manually and making split-second decisions. This resulted in fewer registration errors and less time spent on rework and training.
With this new tool, staff were able to support payer selection and eligibility verification while retaining final decision authority. and why Patient Access Curator Integrates directly into existing systems, staff can follow the same steps regardless of environment or equipment. As a result, variation decreased and enrollments became more consistent.
Results: Immediate improvements in accuracy, efficiency and visibility.
| Patient Access Curator Results: |
| – 41% reduction in eligibility denials |
| – 37% decrease in benefits coordination and registration denials. |
| – 97% coverage accuracy |
Front-end teams saw improvements immediately. With Patient Access Curator By taking care of eligibility and coverage verifications, staff spent less time on manual tasks and no longer needed to perform the same verifications multiple times.
Better data means better data flowing through the entire system, further reducing the workload that would otherwise arise from rework and bounced mail. Coverage accuracy reached 97% in hospital and professional billing, reflecting significant improvements in baseline data quality.
Most importantly, fewer errors exceeding registration made a measurable difference in denial rates, resulting in a 41% reduction in eligibility denials and a 37% drop in coordination of benefits and registration denials.
For leadership, Patient Access Curator’s built-in denial analysis offered a more detailed view of performance. “Patient Access Curator “It gave us data visibility we never had with our previous provider,” says Joyce Predmore, Director of Patient System Access and Financial Authorization at CRH. This meant they were able to “significantly reduce time spent reviewing denials and retraining staff.”
Collaborating to keep performance on point
CRH continued to work closely with Experian Health to take advantage of these improvements after implementation. Regular performance reviews and ongoing denial analyzes helped teams identify eligibility patterns and adjust workflows as necessary. Predmore says this partnership was key to helping them respond quickly to changing payer rules.
“Experian Health facilitated meetings with specific payers and kept us informed if anything was happening in Indiana. That communication has been critical to our success.”
Joyce Predmore, Director of Patient System Access and Financial Authorization, Columbus Regional Health
CRH plans to use the same collaborative approach to address other sources of denials, such as claim attachments, and further improve its workflows and alerts.
Find out how Experian Health works Patient Access Curator Helps healthcare organizations reduce denials and improve initial accuracy.