Ask the Expert: EMV, Encryption and Reducing Your PCI Scope

Tony Hansen is a Payment Card Industry Professional (PCIP) at Providence Health Systems. Providence is the third largest not-for-profit health system in the U.S., operating 34 hospitals in five states. Earlier this year, Tony met with a group of Epic Users about the importance of EMV and how encryption helps reduce PCI scope and protect against the threat of fraud and stolen personal data.

Below are the insights and advice Tony shared regarding some of the most frequently asked questions about

Tagged Best Practice, Compliance and Security, EMV, HIPAA, PCI compliance, PCI scope, PCI-DSS

Enhance the Consumer Payment Experience: Opportunities for Payers

A decade ago, the consumer’s role in the healthcare decision-making process was drastically different. Payers and employers managed virtually all of the health benefit decisions for consumers. Consumers were presented with one or two choices for a benefits package, visited the providers in their network and paid a minimal copay, if anything at all. Payment associated with healthcare services generally was not a focal point for consumers.

In recent years, the payment responsibility has shifted (and continues to shift) to the

Tagged Administrative Costs, Best Practice, Consumerism, healthcare payments, increase collections

Latest Trends and Practices for Payers to Prepare for the Future

A previous post detailed the latest trends in healthcare payments impacting how providers do business and best practices for providers to meet those challenges. However, the latest trends in healthcare payments present unique challenges for payers, which they must adequately prepare for – or risk consumer dissatisfaction and lost revenue.

Data from the 2013 Trends in Healthcare Payments Annual Report demonstrates that healthcare payments industry is evolving and outlines how payers can manage these changes. In particular, healthcare consumerism and provider

Tagged Best Practice, CAQH, Consumerism, ERA/EFT, healthcare payments, payers

ERA/EFT Mandate: Impacts to Providers

In 2014, all payers will be federally mandated to support electronic funds transfer (EFT) and electronic remittance advice (ERA) in accordance with the requirements specified in the CAQH CORE Operating Rules. Providers may be wondering how this mandate will affect payer payments and what you must do to be compliant.

Under the mandate, providers have no obligation to accept ERA/EFT from payers. However, the mandate enables providers to improve efficiency and reduce administrative costs. Read on to learn more about how

Tagged Administrative Costs, Best Practice, CAQH, Compliance, ERA/EFT, payers, providers

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

Transforming Patient Statements: A Hospital’s Best Practices

While patient statements are an essential part of the patient payments process, statements can significantly add to the administrative time and costs to collect. When considering administrative improvements, Good Samaritan Hospital realized that many of its inefficiencies existed in the patient statements process. Below is an outline of how Good Samaritan identified issues in its patient statements process and improved these areas by applying statement best practices. As a result, Good Samaritan significantly reduced its costs to collect patient payments

Tagged Administrative Costs, Best Practice, healthcare payments, increase collections, patient payments, patient statements, providers

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

3 Essentials to Collecting More Payments

The increase in self-pay patients and rising operational costs are driving healthcare providers to seek out tools and strategies to operate more efficiently and collect more from patients. Depending on your current processes to collect, there are various changes you can make that can have a significant impact on the amount collected and the time and costs spent to collect. Below are three common process issues that billing service Medical Management Corporation of America (MMCOA) faced with its providers, and

Tagged Administrative Costs, Best Practice, Consumerism, healthcare payments, increase collections, integrated healthcare payments, patient bad debt, patient payments, patient responsibility, payment assurance, payment card, payment strategies, providers

Going Electronic? How to Get Your Providers on Board

In 2020, 26% of surveyed healthcare payers said that more than half of their provider networks still don’t accept ERA/EFT (Trends in Healthcare Payments Annual Report). Despite the HHS operating rule on EFT standards which went into effect in 2014 and mandated that payers had to adopt ERA/EFT, 84% of surveyed healthcare providers indicated they continue to receive paper checks from one or more payers.

The sooner providers accept electronic payments, the more money payers and providers can save. So how can you

Tagged Administrative Costs, Best Practice, Compliance, ERA/EFT, healthcare payments, healthcare reform, payer-to-provider payments, payers, reconciliation, remittance

Blog Post Topic: Best Practice