The Top 3 Essentials of Payment Security in Healthcare

Guest Blogger: Jeff Lin, Senior Vice President of Product Management, InstaMed

The Washington Post has deemed 2015 “the year of the healthcare hack” with multiple large-scale breaches already compromising the data of more than 100 million U.S. consumers. An issue compounding healthcare’s vulnerability is the rapid increase of consumer payment responsibility since the Affordable Care Act (ACA).

Healthcare organizations are seeking ways to connect electronically with consumers to streamline the payments process, improve cash flow and ensure data security, which can significantly

Tagged Affordable Care Act, EMV, healthcare payment security, healthcare payments, P2PE, patient responsibility, PCI-DSS

Communication: The Key to Collecting More

With the increase in consumer-directed healthcare, patient payments are becoming a more important part of healthcare provider revenue. However, as consumers, patients are accustomed to having a clear understanding of the amount owed prior to making a purchase. Too often in the healthcare industry, patients are clueless about their payment responsibility until they receive a statement. And when patients are confused or uninformed, they are less likely to pay.

Faced with the challenge of collecting more patient payments, Canopy Partners, a

Tagged Affordable Care Act, Best Practice, Consumerism, Eligibility, healthcare payments, increase collections, patient estimation, patient payments, patient responsibility, payment assurance

Latest Trends in the Healthcare Payments Industry

The U.S. healthcare payments market is growing and changing rapidly – in fact, it is estimated to have reached $2.7 trillion as a total of payer and patient payments (IDC Health Insights). The fast evolving healthcare payments industry is impacting the way both payers and providers do business.

This week, the 2012 Trends in Healthcare Payments Annual Report was released to highlight the trends impacting the growing industry and the steps that many payers and providers have taken to accommodate for

Tagged Administrative Costs, Affordable Care Act, Best Practice, Consumerism, healthcare payments, healthcare reform, InstaMed Network, trends in healthcare payments

Key Considerations for Achieving ERA/EFT

On January 1, 2014, all payers will be required to support electronic funds transfer (EFT) and electronic remittance advice (ERA). When evaluating how to achieve ERA/EFT, one of the first decisions a payer will need to make is to “build or buy” – whether to use internal resources to build ERA/EFT capability or to work with a third-party vendor.

Regardless of which model a payer follows to achieve ERA/EFT, there are several key considerations that need to be included in the

Tagged Administrative Costs, Affordable Care Act, Best Practice, CAQH, Compliance, CORE, ERA/EFT, healthcare payments, healthcare reform, payer-to-provider payments

How to Keep Your Provider Network Happy

For a healthcare payer’s provider network, the process to get paid has always been a challenge. The steps providers take each day, from verifying eligibility and submitting claims, to receiving and reconciling payments, are filled with manual work, paper, errors and delays. As a result, the fragmented, time-consuming and often stressful process to collect payments is adding a lot of cost pressure on providers.

New healthcare reform mandates also put pressure on providers to find ways to get paid more efficiently.

Tagged Administrative Costs, Affordable Care Act, Best Practice, Eligibility, ERA/EFT, healthcare payments, healthcare reform, increase collections, patient estimation, payer-to-provider payments, payers, payment assurance, payment strategies, private cloud, providers, reconciliation, remittance

Top 3 Misconceptions of Collecting from Patients

Many healthcare providers are concerned about the impact to their businesses that will result under PPACA. Much of this concern is due to the additional 20 to 30 million uninsured Americans that will begin to receive new healthcare coverage in 2014. With more patients eligible to receive healthcare services, and hundreds of millions of patient payments transactions being added to the U.S. healthcare system, the difficulties providers face with patient collections is becoming a high priority issue.

Shifting the focus to

Tagged Administrative Costs, Affordable Care Act, Best Practice, Compliance, Consumerism, Eligibility, healthcare payments, healthcare reform, increase collections, patient bad debt, patient estimation, patient payments, patient responsibility, payment, payment assurance, payment card, payment strategies, PCI-DSS, providers

What the New EFT Regulations Mean for You

Guest Blogger: Bill Marvin, President & CEO, InstaMed

In an earlier post, I commented on the HHS interim final rule adopting electronic funds transfer (EFT) standards, which was released in January 2012. In the post, I outlined the following changes needed in order for the new EFT regulations to truly improve efficiency and deliver cost savings for healthcare payers and their provider networks:

1. Add a Trace Number Requirement

The rule should require that the EFT and the electronic remittance advice (ERA) have

Tagged Administrative Costs, Affordable Care Act, Best Practice, CAQH, Compliance, CORE, ERA/EFT, healthcare payments, healthcare reform, Medical Loss Ratio, patient responsibility, payer-to-provider payments, payers, providers, reconciliation, remittance, reporting

Why the New EFT Rule Could Have Been Better

Guest Blogger: Bill Marvin, President & CEO, InstaMed

Recently, the Centers for Medicare & Medicaid Services (CMS) announced a final rule adopting electronic funds transfer (EFT) standards, which are part of the ACA provisions that call for improved administrative efficiency. While this rule is just one piece of the ACA operating rules, the adoption of the rule for EFT standards lays a positive foundation for the future of both EFT and ERA (electronic remittance advice). However, a couple of serious flaws

Tagged Administrative Costs, Affordable Care Act, Best Practice, ERA/EFT, healthcare reform, payer-to-provider payments, payers, providers, reconciliation, remittance

Electronic Payments: 4 Requirements to Integrate EFT with ERA

Healthcare reform is a major factor driving change in payer-to-provider payments, including the medical loss ratio (MLR) requirement in PPACA. To reduce administrative costs and meet the MLR mandate, payers are implementing more efficient payment delivery methods. One such method is the offering of ERA/EFT, which combines both the payment and the healthcare payment information to enable provider funding, posting and reconciliation. While many payers have been sending providers ERAs (electronic remittance advice) for years, it’s time for payers to

Tagged Affordable Care Act, CAQH, Compliance, CORE, EHNAC, ERA/EFT, healthcare payments, healthcare reform, HIPAA, ICD-10, Medical Loss Ratio, NACHA, payer-to-provider payments, payers, PCI, providers, remittance, SSAE 16

5 Risks for Payers in the Healthcare Payments Landscape

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The lack of payment assurance in healthcare poses a problem for the industry, during a time of rising consumerism and healthcare reform. Here are the top five risks of the lack of payment assurance to the healthcare payer.

1. Provider Network Satisfaction/Discounts

Providers will become increasingly dissatisfied with the arrangements that they have made with payers. Healthcare reform like MLR adds administrative cost pressures that will

Tagged Affordable Care Act, Consumerism, healthcare payments, healthcare reform, Medical Loss Ratio, payers, payment assurance, providers

Blog Post Topic: Affordable Care Act