As we pack our bags and prepare for HIMSS19 in Orlando, I
started to think about all the touchpoints where data and information can be
comprised when traveling. Even though travel and healthcare are two very
different industries, they both have multiple consumer touchpoints where
security can be compromised. Let’s take a look at what healthcare can learn
from traveling to HIMSS19.
Booking Your Flight
Today, most of us go online to book our flights and hotels
rooms. In just a few clicks, we can choose our
November is a time to reflect and give thanks for all the good things in our lives. As a security officer, I am additionally thankful for accomplishments in the field of security and compliance that help us better protect payment data and prevent data breaches in healthcare. Around this time four years ago, we were not so thankful for the massive breach that affected Target stores and compromised the credit and debit card information of 110 million consumers – right
We listened. We learned. We collaborated. We even had a little fun. In no particular order, here are our top 10 favorite moments from the InstaMed 2016 User Conference.
See a Video Recap
Our Keynote Speaker Emphasized the Impact of the Digital Experience in Healthcare
We kicked off our conference with a keynote presentation from Brian P. Kalis of Accenture Digital. Brian delivered a data-driven overview of the changing nature of healthcare payments, including a look at the market disruptors that are influencing
As every new year begins, consumer deductibles reset to their annual maximum amount that can range on average from $1,000 to $2,000 – up nearly 50% since 2009 (Kaiser Family Foundation). To prepare for increased consumer collections, healthcare organizations must evaluate their collection methods to ensure these consumers can quickly and conveniently make their payments, and more importantly, that their payments are secure.
We discussed in a previous blog post the latest innovations in payment technology and security, as well as
Recent healthcare news announcements indicate that another major clearinghouse has disappeared. This is a trend that started a few years ago and will continue. In fact, of the top clearinghouses from five years ago, only a portion are still in business, some of which are in the process of exiting the business through strategic sales by their equity investors.
Why are clearinghouses disappearing?
One of the major factors contributing to the disappearance of clearinghouses is the fact that most clearinghouses are
A previous post covered how consumerism is impacting the healthcare payments industry and detailed how payers and providers can work together to take advantage of this trend.
However, the rise of consumerism in the healthcare industry presents unique challenges for payers to engage their members, which they must adequately prepare for – or risk consumer dissatisfaction and lost revenue.
Risks and Opportunities of Healthcare Consumerism for Payers
A decade ago, payers and employers managed almost all of the health benefit decisions for patients. As
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
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
Recently, we posted a list of five things that payers can do now to prepare for upcoming reform mandates (click here to read the post). This post emphasizes the importance of collaborating with other organizations like clearinghouses, trading partners and vendors, in order to achieve compliance with the mandated CAQH CORE Operating Rules. These relationships are crucial regardless of the approach payers take to achieve compliance.
Below is an outline of the three main models payers can use to meet the
What Are Operating Rules?
Under the Patient Protection and Affordable Care Act (PPACA), the Operating Rules (developed by CAQH CORE) define the guidelines and standards for making electronic healthcare transactions more predictable and consistent, so the industry can be more efficient.
Upcoming mandated Operating Rules include:
Eligibility and Claim Status: Phases I and II
Deadline for payer compliance: January 1, 2013
Why providers should care:
With mandated standards for electronic eligibility transactions, it will be easier for providers to connect to payers to verify patient eligibility