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Traditionally, the end-to-end healthcare payments process – from submitting claims to receiving, posting and reconciling payments – has been disjointed and manual, requiring a great deal of paper and leading to errors and delays in payment.  However, as providers continue to feel pressure to reduce costs, leveraging integrated technology to streamline these processes is becoming increasingly important.  Here’s Eastside Pediatrics’ story and the success they achieved with integrated healthcare payments:

A Series of Problems

Inefficient Claims and Remittance Management Processes

On an “easy day” Eastside Pediatrics staff spent two hours on claims submission, as the process was extremely manual.  Once claims were submitted, the staff did not receive acknowledgement that the claims were accepted and delivered to payers until many days later, and staff frequently had to reprocess and resubmit rejected claims.

Slow Patient Checkout Process

To collect patient responsibility, Eastside Pediatrics processed credit cards using a single bank terminal, which used a slow dialup connection through the practice’s fax line, resulting in a slow checkout process for the 98 percent of patients that pay with credit cards.

Difficult Reconciliation with Stacks of Paper

As the practice’s bank terminal was not integrated with its practice management system (PMS), the staff had to add up stacks of paper receipts at the end of each day to reconcile payments.  If an error occurred during the time of payment – for example, if a staff member did not correctly identify which patient made a particular payment – the process to resolve this error and reconcile the payment was slow and inefficient.  Each day, the practice staff spent hours on these processes.

An Easy Solution

Integrated Clearinghouse and Comprehensive Reporting

By integrating claims processing with its PMS, the practice now spends just a few minutes each morning to submit claims.  Within an hour, the practice receives an easy-to-read report showing that the claims went through, or indicating any corrections that need to be made.  Additionally, the staff can check the status of claims in batch or real-time throughout the day.  The practice also receives ERAs (electronic remittance advice) that posts directly into its PMS, eliminating paper checks and EOPs (explanation of payment) and simplifying reconciliation.

Efficient Patient Payments with Automated Posting

Eastside Pediatrics processes card payments securely using swipe devices attached to each computer through a secure, private cloud.  All patient payments automatically post into the PMS for easy reconciliation, so the staff no longer needs to manually add up and reconcile stacks of paper receipts each day.  This has saved the practice significant time and effort in its day-to-day workflow.

Drastic Results with Integrated Healthcare Payments

  • Reduced time spent on claims submission and patient payment processing by 88%
  • Reduced claim rejections
  • Reduced costs by going paperless
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