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

Tagged Administrative Costs, Best Practice, CAQH, Compliance, ERA/EFT, payers, providers

Interoperability: Beyond the Clinical Side of Healthcare

Growing need for interoperability

Healthcare reform is driving a greater need for efficiency, resulting in the formation of Accountable Care Organizations (ACOs) and provider consolidation. As provider organizations using different systems work together, there is a much greater need to integrate heterogeneous environments to achieve system interoperability. However, healthcare information is often not easily exchanged among providers because of paper-based processes or systems that are not compatible. In fact, 71% of providers surveyed said the lack of system interoperability is a

Tagged Administrative Costs, healthcare reform, integrated healthcare payments, patient payments, providers, trends in healthcare payments

Transforming Patient Statements: A Hospital’s Best Practices

While patient statements are an essential part of the patient payments process, statements can significantly add to the administrative time and costs to collect. When considering administrative improvements, Good Samaritan Hospital realized that many of its inefficiencies existed in the patient statements process. Below is an outline of how Good Samaritan identified issues in its patient statements process and improved these areas by applying statement best practices. As a result, Good Samaritan significantly reduced its costs to collect patient payments

Tagged Administrative Costs, Best Practice, healthcare payments, increase collections, patient payments, patient statements, providers

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

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.

Tagged Administrative Costs, Affordable Care Act, Best Practice, Eligibility, ERA/EFT, healthcare payments, healthcare reform, increase collections, patient estimation, payer-to-provider payments, payers, payment assurance, payment strategies, private cloud, providers, reconciliation, remittance

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

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