Enhance the Provider Experience: Deliver Payment Assurance

In an earlier post, we discussed one of the major threats to the payer-provider relationship: the provider’s lack of payment assurance. This threat poses an opportunity to payers to give their provider networks the tools needed to achieve payment assurance. In our previous post, we gave tips for payers to deliver payment assurance to their providers. Below, we’ve included a graphic of the Payment Assurance Framework to demonstrate how payers can deliver payment assurance to providers in each step of the healthcare

Tagged Administrative Costs, Best Practice, Claims, Clearinghouse, Eligibility, ERA/EFT, healthcare payments, patient estimation, patient payments, patient responsibility, payer-to-provider payments, payers, remittance

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

5 Reasons to Accept Online Patient Payments

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The rise of consumerism in healthcare is driving providers to evaluate how they approach healthcare payments. To collect more from patients and reduce administrative costs, providers need to offer more convenient, consumer-friendly options, such as online patient payments.

In today’s world consumers want ease and convenience in many aspects of their lives, including being able to pay their bills online. As more people turn to

Tagged Administrative Costs, Consumerism, healthcare payments, increase collections, online payments, patient bad debt, patient payments, patient responsibility, payment, payment assurance, practice management system, providers, reconciliation

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

Achieving Success with Integrated Healthcare Payments

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

Tagged Administrative Costs, Claim Status, Claims, Clearinghouse, ERA/EFT, healthcare payments, increase collections, patient payments, payment card, practice management system, private cloud, reconciliation, reporting

Blog Post Topic: Administrative Costs