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

Tagged Best Practice, CAQH, Consumerism, ERA/EFT, healthcare payments, payers

Risks and Opportunities of Healthcare Consumerism for Payers

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

Tagged Compliance, Consumerism, Explanation of Benefits, healthcare payments

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

Tagged Affordable Care Act, Best Practice, Consumerism, Eligibility, healthcare payments, increase collections, patient estimation, patient payments, patient responsibility, payment assurance

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

Tagged Administrative Costs, Affordable Care Act, Best Practice, Consumerism, healthcare payments, healthcare reform, InstaMed Network, trends in healthcare payments

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

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

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

The Latest Technology Best Practice in Payment Card Security

The Problem

As the rise in healthcare consumerism becomes one of the most influential industry trends, more healthcare providers are accepting payment cards in order to collect more patient payments. However, the prevalence of data breaches in healthcare – many of which involve patient payment card data – also is increasing. The financial and reputational cost of a payment card data breach is high and may result in bad publicity and loss of business. To reduce the risk of a breach,

Tagged Coalfire, Consumerism, Data Breach, healthcare payments, patient payments, payment card, Payment Card Encryption, PCI-DSS, providers, SSL, trends in healthcare payments

Steps to Payment Assurance: A New Model for Healthcare Providers

Think of the payment assurance that Best Buy has in a payment transaction: it allows a consumer to walk out of its store with a thousand-dollar television, even though the payment is not yet in the company’s bank account in the form of available funds. The only thing Best Buy has to fall back on is its trust in an authorization, delivered by a payments network, after a consumer’s payment card is processed. Imagine telling Sam Walton in 1960 that

Tagged Claims, Consumerism, Eligibility, ERA/EFT, healthcare payments, increase collections, integrated healthcare payments, patient estimation, patient payments, patient responsibility, payers, payment assurance, payment strategies, providers

5 Risks for Payers in the Healthcare Payments Landscape

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The lack of payment assurance in healthcare poses a problem for the industry, during a time of rising consumerism and healthcare reform. Here are the top five risks of the lack of payment assurance to the healthcare payer.

1. Provider Network Satisfaction/Discounts

Providers will become increasingly dissatisfied with the arrangements that they have made with payers. Healthcare reform like MLR adds administrative cost pressures that will

Tagged Affordable Care Act, Consumerism, healthcare payments, healthcare reform, Medical Loss Ratio, payers, payment assurance, providers

Blog Post Topic: Consumerism