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[Infographic] ERA/EFT Adoption by the Numbers

In 2014, all payers were 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. Though the mandate went into effect in January 2014, the industry has been slow to adopt the electronic alternative to paper checks. Many organizations send a high dollar volume through ERA/EFT, but it’s the low percentage of transactions sent through ERA/EFT that keeps print and mail costs high. The costs

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Case Study: Geisinger Health Plan Delivers 85% of Provider Payment Transactions Via ERA/EFT

Geisinger Health Plan (GHP) needed a change when it came to their provider payments. The old process to send electronic payments was time-consuming and expensive – yet, two-thirds of their provider network still received paper checks.

GHP chose to partner with InstaMed to bring about some much needed change. With InstaMed, GHP now delivers 85% of provider payment transactions via ERA/EFT and increased annual revenue by $642k. How did they do it? View the infographic below, then read the case study

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Why Are Payers Still Talking About ERA/EFT Adoption?

It sounds like a great achievement – 80 percent of dollar volume sent as ERA/EFT to providers! You’re only 20 percent away from full ERA/EFT adoption, right? Not quite. Some in the industry would have you believe they have achieved huge milestones when it comes to ERA/EFT adoption, but usually the achievements are quantified in dollar volume. ERA/EFT adoption is still low, as 88 percent of providers report receiving paper payments from one or more of their payers. So while

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The Sixth Annual Trends in Healthcare Payments Report is Here!

The Trends in Healthcare Payments Sixth Annual Report: 2015 is now available to download – free of charge. For the last six years, InstaMed has released this report to objectively educate the market and promote awareness, change and greater efficiency through quantitative data from the InstaMed Network and qualitative data from healthcare providers, payers and consumers surveyed nationwide.

Click here to download the report.

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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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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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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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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 (read more: 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

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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

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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. 

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