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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

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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

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Latest Trends and Practices for Payers to Prepare for the Future

A previous post detailed the latest trends in healthcare payments impacting how providers do business and best practices for providers to meet those challenges.  However, the latest trends in healthcare payments present unique challenges for payers, which they must adequately prepare for – or risk consumer dissatisfaction and lost revenue.

Data from the 2013 Trends in Healthcare Payments Annual Report demonstrates that healthcare payments industry is evolving and outlines how payers can manage these changes. In particular, healthcare consumerism and provider

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Meeting Challenges of Latest Healthcare Payments Trends

The healthcare payments industry is growing at a rapid pace; however, 25 to 40 cents of every healthcare dollar are spent on administrative costs. These costs are only poised to increase as changes due to reform and consumerism continue to reshape the industry – impacting the way many providers do business.

Data from the 2013 Trends in Healthcare Payments Annual Report confirms that the healthcare payments industry is evolving and outlines how providers can manage these changes. In particular, growth in

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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

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Communication: The Key to Collecting More

With the increase in consumer-directed healthcare, patient payments are becoming a more important part of healthcare provider revenue. However, as consumers, patients are accustomed to having a clear understanding of the amount owed prior to making a purchase.  Too often in the healthcare industry, patients are clueless about their payment responsibility until they receive a statement. And when patients are confused or uninformed, they are less likely to pay.

Faced with the challenge of collecting more patient payments, Canopy Partners, a

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Latest Trends in the Healthcare Payments Industry

The U.S. healthcare payments market is growing and changing rapidly – in fact, it is estimated to have reached $2.7 trillion as a total of payer and patient payments (IDC Health Insights).  The fast evolving healthcare payments industry is impacting the way both payers and providers do business.

This week, the 2012 Trends in Healthcare Payments Annual Report was released to highlight the trends impacting the growing industry and the steps that many payers and providers have taken to accommodate for

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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

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Key Considerations for Achieving ERA/EFT

On January 1, 2014, all payers will be required to support electronic funds transfer (EFT) and electronic remittance advice (ERA).  When evaluating how to achieve ERA/EFT, one of the first decisions a payer will need to make is to “build or buy” – whether to use internal resources to build ERA/EFT capability or to work with a third-party vendor.

Regardless of which model a payer follows to achieve ERA/EFT, there are several key considerations that need to be included in the

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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

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