InstaMed Blog Archives

Hold the Phone! Tips on Reducing Call Center Volume

With new regulatory mandates like the medical loss ratio (MLR) pressuring the healthcare industry to improve efficiency, payers and emerging ACOs are looking at ways to reduce administrative costs.  For many organizations, one of the more obvious areas in need for greater efficiency is the call center.

In the last decade, the increase in provider call volume has become a growing concern (see: “Health Insurance Call Volume Increasing”).  In fact, according to the 2011 Trends in Healthcare Payments Annual Report, call

Read More

What the New EFT Regulations Mean for You

Guest Blogger: Bill Marvin, President & CEO, InstaMed

In an earlier post, I commented on the HHS interim final rule adopting electronic funds transfer (EFT) standards, which was released in January 2012.  In the post, I outlined the following changes needed in order for the new EFT regulations to truly improve efficiency and deliver cost savings for healthcare payers and their provider networks:

1. Add a Trace Number Requirement

The rule should require that the EFT and the electronic remittance advice (ERA) have

Read More

New Reform Mandates: What Can Providers and Payers Expect

Now that we are certain about new regulatory mandates and the direction of healthcare in the U.S., the industry can refocus its efforts on preparing for the road ahead.  Here’s a look at what we can expect in healthcare payments in the next decade:

More Coverage = More Patient Payments

Approximately 30 million uninsured Americans will begin to receive healthcare coverage in 2014. While the enrollment process will take multiple years, we believe that the majority of this group will receive coverage

Read More

Latest Trends in Healthcare Payments for Providers and Payers

The latest trends in the healthcare industry — the rise in consumerism, increase of costs and new regulatory mandates — are driving change in the healthcare payments process. As health insurance premiums continue to grow, employers are switching to lower cost, high-deductible plans, resulting in an overall decrease in payer payments and, consequently, an increase in patient payments. As a percentage of provider revenue, in 2009, payer payments represented 79% of the allowed amount, while patient payments represented 21%. In

Read More

Electronic Payments: 4 Requirements to Integrate EFT with ERA

Healthcare reform is a major factor driving change in payer-to-provider payments, including the medical loss ratio (MLR) requirement in PPACA. To reduce administrative costs and meet the MLR mandate, payers are implementing more efficient payment delivery methods. One such method is the offering of ERA/EFT, which combines both the payment and the healthcare payment information to enable provider funding, posting and reconciliation. While many payers have been sending providers ERAs (electronic remittance advice) for years, it’s time for payers to

Read More

5 Risks for Payers in the Healthcare Payments Landscape

We’ve discussed the lack of payment assurance in healthcare and why this poses a problem for the industry today, during a time of rising consumerism and new 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 force providers to re-assess their network relationships — which

Read More

Webinar: Integrate Payer Payments and Prepare for Reform Mandates

This webinar has already occurred.

As costs rise in healthcare and the new reform mandates are implemented, payers face the ever-present challenges of cutting costs, meeting regulatory mandates and ensuring provider network satisfaction.  Payers can overcome these challenges by streamlining payer-to-provider payments using a simple, secure solution.

This webinar features the following healthcare payments industry experts and payers:

IDC Health Insights will present on the healthcare payment market drivers for payers, including regulatory pressures like Medical Loss Ratio (MLR), growth in self-pay members

Read More

Download PDF

Thank you for your interest in InstaMed. Please complete and submit the webform below and your PDF Download will become available.

  • Cancel

Thank you for your interest in InstaMed.

Please click the link below to download your PDF.

Download PDF

To learn more about InstaMed, please click here.