The need for an omnichannel payments experience in healthcare is greater than ever before. Rising patient payment responsibility, mergers and acquisitions, and innovations in payment technology have all created new opportunities for healthcare providers to collect payments. Embracing an omnichannel approach to patient payments can positively impact a healthcare organization’s revenue, brand awareness and patient satisfaction scores. However, failure to implement omnichannel payments can have the opposite effect.
Here’s everything you need to know about omnichannel payments and why they matter
The healthcare industry has been focused on understanding and adapting to the new impacts of healthcare consumerism, and for good reason; The Sixth Annual Trends in Healthcare Payments Report identified consumerism as one of the major trends impacting healthcare organizations today. In a separate blog post this month, InstaMed CTO and co-founder, Chris Seib, outlines some of the most critical consumer payment behaviors that affect healthcare providers today.
While healthcare organizations should continue improving the consumer experience, new processes should not
What Are Operating Rules?
Under the Patient Protection and Affordable Care Act (PPACA), the Operating Rules (developed by CAQH CORE) define the guidelines and standards for making electronic healthcare transactions more predictable and consistent, so the industry can be more efficient.
Upcoming mandated Operating Rules include:
Eligibility and Claim Status: Phases I and II
Deadline for payer compliance: January 1, 2013
Why providers should care:
With mandated standards for electronic eligibility transactions, it will be easier for providers to connect to payers to verify patient eligibility
Last year, the majority of surveyed healthcare payers said that less than half of their provider networks did not accept ERA or EFT (read more: 2011 Trends in Healthcare Payments Annual Report). Of the providers who did not accept ERA or EFT during the time of this survey, nearly half said the reason was that they simply preferred paper.
However, according to the HHS interim final rule on EFT standards, payers will need to adopt ERA/EFT by January 1, 2014; and,
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
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
The rise of consumerism in healthcare is driving providers to evaluate their tactics to collect healthcare payments. While providers previously relied almost exclusively on payer payments for their revenue, patient responsibility is increasing as a portion of provider revenue. In order to collect more from patients and reduce administrative costs, providers need to offer more convenient, consumer-friendly payment options, such as online patient payments.
According to the 2011 Trends in Healthcare Payments Annual Report, online patient payments have tripled since 2009.
Guest Blogger: Bill Marvin, President & CEO, InstaMed
Recently, the Centers for Medicare & Medicaid Services (CMS) announced a final rule adopting electronic funds transfer (EFT) standards, which are part of the ACA provisions that call for improved administrative efficiency. While this rule is just one piece of the ACA operating rules, the adoption of the rule for EFT standards lays a positive foundation for the future of both EFT and ERA (electronic remittance advice). However, a couple of serious flaws
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