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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 fuels these negative experiences and makes it harder for providers and health plans to deliver what matters most – important and necessary care. I hope to illustrate how health plans can change healthcare’s current state to improve the payment experience for providers and members.

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 the low percentage of transactions sent through ERA/EFT keeps print and mail costs high. The costs and inefficiencies of paper payments negatively impact both health plans and providers.

Consider that 84 percent of providers prefer to receive EFT from health plans. Yet, a staggering 84 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 receives 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 multi-channel marketing outreach to drive awareness and get providers registered. Our team is 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 the importance of provider relationships to health plans 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

InstaMed helps health plans deliver more electronic payments 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 achieved annual cost savings of $455k and increased annual revenue by $642k. To read more about GHP’s success, download the full case study.

Learn more about how we are driving the path to 80% ERA/EFT adoption.

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