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

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

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

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

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

True Availability – Part 2: Cloud Protection

Guest Blogger: Chris Seib, Co-Founder & CTO, InstaMed

Last week, I highlighted some common oversights by businesses when leveraging a private cloud that increase the risk of long-term data outages, and detailed the best practices and tips to use in discussions with current or potential vendor partners in order to protect your business. Below is Part 2 of this post, focusing on disaster recovery, business continuity and security.

Disaster Recovery

Even with high degrees of local redundancy in a private cloud data center,

Tagged Best Practice, Compliance, Disaster Recovery, EHNAC, HIPAA, HITECH, PCI, private cloud, security, SSAE 16

Blog Post Topic: Best Practice