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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,

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8 Things ACOs Need to Know About Healthcare Payments

What Is an ACO?

An ACO (accountable care organization) is a healthcare organization made up of providers and payers who come together to give coordinated, patient-centered care. In the public sector, ACOs earn incentives for delivering high-quality care and reducing healthcare costs for Medicare and Medicaid patients. In the private sector, ACOs focus on achieving a high level of wellness and satisfaction for all patients.

What You Should Know About ACO Payments:

1. Increase focus on collecting from patients. As providers work to

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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

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Real-Time Adjudication – Is This the Silver Bullet?

Over the past 10 years, one of the top administrative priorities for the healthcare industry has been the development of real-time adjudication (RTA) for healthcare claims. By 2005, the RTA effort had attracted a great deal of attention and effort across the industry. However, five years later, the results delivered have been underwhelming for both providers and payers.

The Core Problems

Although RTA makes sense from a high-level standpoint, the healthcare transaction process has nuances, both from a technology and business perspective.

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Choosing the Right Clearinghouse: 5 Essential Qualities

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In the healthcare industry, the clearinghouse you work with has a huge impact on your business. The more efficiently your clearinghouse processes and returns your information, the faster you will get paid, and the more payments you will collect.

To gain insight into what providers need from a clearinghouse, we interviewed Kevin Milam, owner of The Billing Center, which does billing, consulting and accrediting for

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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

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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

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