At A Glance
Learn how automated financial assistance screening can help reduce bad debt, support more consistent financial assistance decisions and support a better, more compassionate patient financial experience. Patient Financial Clearance is now available with Experian Verify, adding verified income and employment data to the screening workflow.
Key takeaways:
- Changing regulation and coverage rules are making it harder to continue relying on manual processes to identify or screen patients for financial assistance.
- Automated financial assistance screening can help providers identify eligible patients earlier, so they can connect them with the right support before a statement is ever sent and the balance turns into aging AR and bad debt.
- Experian Health’s Patient Financial Clearance (PFC), now available with Experian Verify, combines Experian data and analytics with verified income and employment data to support more informed financial assistance decisions.
With Experian Verify, PFC adds income and employment verification with real-time employer data to the financial assistance workflow to support financial assistance, Medicaid, or other program screening. Within Patient Financial Clearance, directly sourced, verified income and employment data can also supplement propensity-to-pay assessments rather than relying only on self-reported information.
Alex Liao, Senior Product Manager for Patient Financial Clearance at Experian Health, says, “Many patients don’t realize they may qualify for financial assistance, and even when they do, the process can be hard to navigate. They often find out what they owe when the bill arrives, and that sticker shock can add stress at an already difficult time. Automating presumptive charity screening up front is more efficient and more reliable than waiting until after care. Patient Financial Clearance pulls together the information needed to determine whether a patient qualifies, without long, drawn-out conversations. That makes the financial experience more compassionate. Patients get help sooner with less worry, and providers can reduce bad debt before it starts.”
Healthcare costs remain a concern for many Americans. In 2025, 26.7 million people (7.9% of U.S. population) were uninsured for the entire year, according to the U.S. Census Bureau. KFF polling from 2026 found that about nine in 10 adults are very or somewhat worried about affording the cost of healthcare.
Changes to Medicaid eligibility under the One Big Beautiful Bill Act (OBBBA) and shifts in Affordable Care Act Marketplace coverage are expected to increase the number of people without health insurance. The Congressional Budget Office estimates the law’s Medicaid provisions will increase the number of people without health insurance by 7.5 million in 2034. Providers need more efficient ways to check patients’ financial assistance eligibility and reduce the risk of avoidable bad debt.
Automated patient financial assistance screening can give providers information they need to route patients to the right financial pathway, reduce manual steps and deliver a more compassionate financial experience.
How medical debt affects patients and hospitals
Many patients who cannot afford their medical bills may delay treatment, skip medications or postpone follow-up appointments. Some turn to credit cards or loans to manage the cost. The burden is emotional too: in the Commonwealth Fund 2025 Affordability Survey, 68% of insured adults with medical debt said it caused them worry or anxiety, often while they were still dealing with the health issue that brought them in. But medical debt doesn’t stay hidden for long. By the time it spills over into other household finances and bills, providers may have fewer opportunities to connect patients with financial assistance or manageable payment options early.
When patients are unable to pay, hospitals absorb the cost through charity care or bad debt, leading to revenue loss and operational strain. Kaufman Hall’s July 2026 National Hospital Flash Report shows bad debt and charity care per calendar day rose 14% year over year, while bad debt and charity care as a share of gross operating revenue was 7% higher year to date than in 2025. Over time, those losses can leave less to invest in staffing, technology and the service patients rely on, so the impact of unpaid bills extends well beyond the balance sheet. Earlier screening may help providers identify accounts eligible for charity care before they are misclassified as bad debt, especially as coverage uncertainty increases.
The challenges of manual charity care screening
Checking eligibility criteria for financial assistance is complex, covering factors such as household income, family size and insurance status. Gathering and analyzing this information manually can be time-consuming, error-prone and difficult to scale, especially as more states introduce requirements for hospitals to screen patients for financial assistance.
Manual processes also make it harder for providers to respond to changing coverage requirements. In an Experian Health webinar on ‘Navigating OBBBA,’ Joel White, national healthcare policy expert and partner at Monument Advocacy, said the OBBBA changes mean providers are increasingly dealing with “coverage in motion,” where a patient’s insurance status changes between scheduling and the point of service. At the same time, hospitals are reporting more uninsured and self-pay patients, adding to the volume of accounts that need screening. For revenue cycle teams, manual processes can make it harder to respond consistently as coverage changes.
Benefits of automating financial assistance screening
Rather than relying on manual applications or self-disclosure, providers can automate patient financial assistance screening using Experian data and analytics to route patients to the right pathway as quickly as possible.
| In practice, that means: |
| – Earlier support for patients: Eligible patients are connected with financial assistance before bills become a barrier to care. |
| – Lower bad debt and uncompensated care: Avoidable write-offs can be reduced by identifying patients who qualify for charity care before balances become uncollectible. |
| – Greater confidence in screening decisions: Consistent, data-driven eligibility screening supports more informed financial assistance decisions and minimizes variation between staff or locations. |
| – More consistent policy application: Financial assistance policies can be applied more consistently across locations and teams. |
| – A better patient financial experience: Patients can learn about their options sooner and find it more straightforward to access support. |
How automation helps with financial assistance and presumptive charity screening
Hospital financial assistance automation streamlines manual eligibility reviews with a standardized workflow, giving staff the information they need to make faster decisions. Experian Health’s Patient Financial Clearance, now available with Experian Verify, does this before or at the point of service to help providers identify who may qualify for financial assistance, who may benefit from payment plans and who may need additional coverage or financial assistance review under new coverage rules.
PFC uses Experian data and analytics to predict each patient’s ability to pay and calculate the best-fit payment plan based on individual needs and circumstances. It also generates scripts for staff to use when presenting options to patients, which supports more empathetic patient financial counseling.
Improving the patient experience with self-service financial assistance
Allowing patients to fill out a financial assistance application using the self-service feature can make it easier to improve the patient experience. Some patients may feel hesitant to discuss their financial situation with a stranger, while many are looking for digital channels to handle their administrative tasks.
Experian Health’s Self-Service Patient Financial Clearance option offers patients a simple and more private way to complete financial assistance eligibility checks, whenever and wherever it suits them. Using a mobile and web-based platform, patients can fill out screening forms and upload supporting documents, then get real-time status updates without having to call their providers. Information is stored securely so staff can check application status as needed.
How Self-Service Patient Financial Clearance works
Self-Service Patient Financial Clearance puts patients in control, so individuals can complete applications and find out whether they’re eligible for financial assistance. This can reduce manual work for staff and free up time for other tasks. For organizations that are still paper-heavy or have a meaningful backlog of paper applications, self-service automation may offer a more convenient alternative for both patients and staff.
Find out more about how Patient Financial Clearance can help providers reduce bad debt and improve the patient experience by automating charity care eligibility screening.
FAQ
Patient financial assistance screening is the process of determining whether a patient qualifies for charity care or other financial assistance before or during the billing process. Automated screening can use financial and demographic data to identify patients who may qualify for assistance more quickly and consistently than manual processes.
Charity care eligibility software uses automation and data analytics to assess a patient’s financial assistance and charity care eligibility. Instead of asking patients to complete paper forms and manually comparing information against Federal Poverty Level guidelines, providers can use a standardized, scalable workflow to support financial assistance decisions.
Many patients who qualify for charity care or other financial assistance may not receive it because manual screening processes are time-consuming, inconsistent, or require patients to apply after receiving a bill. Patient financial assistance screening can help providers identify eligible patients earlier, connect them with available support and reduce avoidable write-offs.
Patient Financial Clearance is now available with Experian Verify, which adds income and employment verification to the financial assistance workflow. Experian Verify can use real-time employer payroll data and other verification methods to support financial assistance, Medicaid and other program screening while reducing reliance on self-reported income.
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