Every year, Symantec publishes an Internet Security Threat Report that explores the current state of cybersecurity across industries, including healthcare. This year’s report revealed a few encouraging findings that showed the healthcare industry has improved the way it approaches cybersecurity. Namely, cybersecurity spending has increased across the industry, as has staffing for security, both inside and outside of IT operations. Increased spending for cybersecurity shows a greater commitment and focus from healthcare organizations to get ahead of security threats. This
Did you know?
30% of dollars in healthcare are wasted – Consumers Union, 2013
In 2014, 35% of providers did not collect patient responsibility at the point of service because they were uncertain about the amount due – Trends in Healthcare Payments Annual Report, 2014
On average, it takes 90 to 120 days to collect patient payments without electronic processes in place – InstaMed Provider Data
Traditionally, the healthcare payments process has been disjointed, involving countless transactions among multiple players across various touch points.
Unpaid patient payments are cutting revenue for hospitals across the country, as shown in this recent article about a large hospital chain with lower-than-expected earnings. According to the Trends in Healthcare Payments Annual Report: 2012, the rapid growth of patient responsibility is creating a need for improved patient collection processes for hospitals.
Aspen Valley Hospital, based in Colorado, also saw the need to improve collection processes. Its staff often missed the opportunity during patient visits to collect payments, instead putting the
What’s ahead for payers?
On January 1, 2013, payers will be required to meet the first set of mandated operating rules for Eligibility and Claim Status, under the Patient Protection and Affordable Care Act (PPACA). Click here to view the complete set of CAQH CORE Eligibility and Claim Status Operating Rules.
What can payers do to prepare?
1. Focus on Education
Frequently, half the battle of preparing for mandates is gathering all of the information you need. CAQH CORE released an analysis and planning
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.
The term “administrative efficiency” has been popping up everywhere in the healthcare industry lately. Most provider organizations, from the solo-physician practice to the large health system, should know that they need to make strides to achieve administrative efficiency. However, how can you measure efficiency to tell if you’ve achieved it, or if your administration is still inefficient?
Faced with these questions, Judy Downing, the Billing Manager at Holly Springs Pediatrics, decided to quantify inefficiency in her practice by identifying her greatest
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
Guest Blogger: Chris Seib, Co-Founder & CTO, InstaMed
Last week, I highlighted some common oversights by businesses when leveraging a private cloud that increase the risk of long-term data outages, and detailed the best practices and tips to use in discussions with current or potential vendor partners in order to protect your business. Below is Part 2 of this post, focusing on disaster recovery, business continuity and security.
Even with high degrees of local redundancy in a private cloud data center,
Guest Bloggers: Bill Marvin and Chris Seib, Co-Founders of InstaMed
Last night, I turned on iTunes Match for the first time and streamed music from iCloud while making dinner. Using the cloud to play music worked great, but it made me wonder: what would happen if the cloud went down and my music was unavailable? For five minutes, or for five hours? I’d be annoyed and inconvenienced, forgetting all about my recent delight and the old way I used to do
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