Challenge: Too many registration errors detected too late
Health systems are under constant pressure to improve cash flow while doing more with the same or fewer resources. For MetroHealth, the rise in claim denials was a symptom of some deeper workflow problems. Busy patient access teams relied on manual enrollment processes, leading to inevitable coverage errors and spotty eligibility verification.
Mary Ann Olschlager, director of revenue cycle operations at MetroHealth, describes how these errors made their way into claims and billing, creating more pressure down the road:
“Our backend teams were bombarded with rework. Morale was low and we were spending time fixing what should never have been broken.”
Mary Ann Olschlager, Director of Revenue Cycle Operations at MetroHealth
Staff spent too much time searching for missing or incorrect information that should have been resolved before the patient’s visit. Turning to third-party agencies to fill the gap was proving costly and inefficient.
They needed a system that could eliminate manual steps and eliminate unnecessary touchpoints. Could MetroHealth find a better way to reduce manual burden and fix problems before they lead to rejections?
Solution: Automation with a human touch
Working with its existing partner, Experian Health, MetroHealth introduced a new automated solution, known as Patient Access Curator™ (PAC)which consolidated multiple registration verifications into a single, streamlined process. This was an update to their current use of Experian Health’s real-time eligibility, and PAC’s AI and machine learning technology caught their attention.
With Patient Access CuratorEligibility, benefit primacy coordination, Medicare identifiers, demographics, and coverage discovery could now be handled in a single transaction. The results were returned directly to their electronic medical record, which was good news for staff who no longer had to jump between portals and websites to verify patient details.
Onboarding was simple, with no new screens or additional steps for registrars. Automation runs quickly and silently in the background, reducing last-minute fixes and follow-up work.
Once the new system was implemented, MetroHealth continued to work closely with Experian Health to refine the setup.
“This solution is truly a partnership. Experian didn’t just activate it. They met with us constantly to modify and improve it.”
Mary Ann Olschlager, Director of Revenue Cycle Operations, MetroHealth
Experian consultants also helped resolve specific pain points, such as fixing Epic’s mapping for a complex payer. Olschlager says staff felt safer because nothing critical was overlooked.
“A member of our contact center staff told me, ‘I love it. My job is so much easier.’ That’s when I knew we had a real win,” he says.
Middle teams also appreciated having fewer tasks to contend with, as their daily workload became more predictable. Spending less time fixing errors and calling patients gave staff more bandwidth for higher-value tasks. Christina Adkins, Cash Application and Express Registration Manager, added that because more errors were caught up front, her team was able to focus more on editing claims, rather than reworking denials.
Results: less reworking, fewer denials
| The numbers matched the staff’s experience: |
| – 44.1% reduction in the coordination of benefit denials |
| – 20.3% drop in registration denials |
| – 37.3% decrease in eligibility denials |
These reductions also translated into tangible operational and financial benefits. With fewer denials to correct, MetroHealth reduced its reliance on third-party contingency services, cutting rates by 35% and saving $250,000 per year. The organization also reassigned three full-time staff members to other departments, increasing capacity in those areas without straining teams.
More time for meaningful work
Routine decisions that had been based on experience and memory were no longer left to chance. Once the manual burden of daily logging work was removed, there was no desire to go back.
“Patient Access Curator Manual labor was eliminated. We cannot go back to human decision making. That’s a thing of the past for us.”
Mary Ann Olschlager, Director of Revenue Cycle Operations, MetroHealth
Importantly, while automation eliminated repetitive manual tasks and decisions, it did not eliminate people from the process. Instead, it changed where they focused their time and attention.
Reflecting on their experience, MetroHealth leaders also emphasize the importance of human collaboration across departments, along with ongoing support from Experian Health to build on early improvements and incorporate them into daily practice. As Adkins says: “Patient Access Curator It is efficient and intuitive, with so much information incorporated. “We can’t imagine going back.”
Learn how Patient Access Curator uses AI to automate eligibility and coverage checks at registration.