Senior Vice President of Business Development
Welcome to the first installation of my blog series for health plans. I came to InstaMed in 2019 to work with health plans of all sizes to deliver seamless payment experiences that drive digital engagement while improving member satisfaction.
Healthcare today is profoundly fragmented from both a clinical and payment perspective. This fragmentation results in regional ecosystems filled with confusion, frustration and sub-optimal provider and member/patient experiences. The continued rise in high-deductible health plans for consumers is fueling these negative experiences and is making it harder for providers and health plans to deliver what matters most – important and necessary care. With this blog, I hope to illustrate how health plans can change the current state of healthcare to improve the payment experience for both providers and members.
For the first blog, we thought we would talk about ERA/EFT adoption. Despite the growing trend of providers preferring electronic transactions from health plans, adoption of ERA/EFT remains low. InstaMed is committed to reducing the amount of paper in healthcare and we guarantee that we can help health plans deliver at least 80% of their claim payment transactions electronically! Let’s take a look at why we believe in this mission and how we help health plans across the country achieve this goal.
Why Are We Still Talking About ERA/EFT?
The ERA/EFT Operating Rules mandate has been in place since 2014, yet the industry still struggles to achieve high transaction adoption rates of ERA/EFT. Many organizations send a high dollar volume through ERA/EFT, but it’s the low percentage of transactions sent through ERA/EFT that keeps print and mail costs high. The costs and inefficiencies of paper payments negatively impact both health plans and providers.
Consider that 82 percent of providers prefer to receive EFT from health plans. Yet, a staggering 91 percent of providers still receive paper checks from one or more health plans. It is clear that EFT is the preferred way to get paid, but adoption is still low. While some health plans have begun the migration to electronic payments, there remains a significant amount of paper going out and much room to accelerate.
The Network Effect Working On Your Behalf
More than half of the U.S. provider market is on the InstaMed Network and therefore receive payments electronically. When a health plan joins the InstaMed Network, they can immediately deliver payments electronically to those providers. Health plans will see value on day-one with upwards of 50 percent or more of their providers already on the InstaMed Network and able to receive EFT immediately.
Provider Adoption – An InstaMed Core Competency
InstaMed’s Provider Adoption Program drives provider enrollment for electronic claim payments delivered from health plans. We have an in-house team of experts that is solely dedicated to this mission. Every new InstaMed health plan customer will work collaboratively with this team to embrace our well-established best practices to conduct campaigns designed to drive thoughtful provider adoption through the prism of their priorities.
Our Provider Adoption Program also includes a multi-channel marketing outreach to drive awareness and get providers registered. Our team is also devoted to making enrollment simple and easy for providers. Your providers have access to customer service, enrollment support and training. Once a provider is enrolled, we don’t stop there. We help guide providers through any questions to make sure the entire process is seamless and simple.
Full-Service Support and Monitoring
Healthcare is a prime target for hackers, so security must be top of mind for health plans. InstaMed delivers ongoing security and compliance to our customers. We focus on KYC to protect health plans against the risk of fraud and money laundering within healthcare transactions.
We know of the importance of provider relationships for our health plan customers and accept responsibility for delivering a great provider experience. That is why we own the end-to-end process, so all payment types are managed through a single vendor relationship. This enables us to monitor and track payments through to settlement and gives you and your providers access to payment details and remittances.
Proven Success – Guaranteed
The InstaMed Claims Settlement solution is designed to get health plans delivering more payments electronically to more providers. We guarantee that health plans can deliver at least 80% of their claim payment transactions electronically within the first year. By delivering 80+% ERA/EFT transactions, health plans can expect to decrease print and mail costs, eliminate or significantly reduce staff time allocated to managing multiple systems and processes for claim payments, meet provider demands for compliant ERA/EFT transactions that fit into their existing workflow, and achieve CAQH CORE Phase III and NACHA compliance immediately.
Geisinger Health Plans (GHP) delivers 91% of provider payment transactions via ERA/EFT. With InstaMed, GHP was able achieve annual cost savings of $455k and increase annual revenue by $642k. To read more about GHP’s success, download the full case study.
Learn more about the InstaMed Claims Settlement solution and how we are driving the path to 80% ERA/EFT adoption.