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There’s Still Too Much Paper in Healthcare

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There are many ways to reduce the amount of paper in the healthcare payments process. Online patient portals, eStatements and check-in stations are paperless ways to improve efficiency and deliver a convenient, consumer-friendly patient experience.

Many providers have taken strides to implement solutions like these and reduce the amount of paper in healthcare payments. However, there is an important difference between less paper and paperless.

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Enhance the Consumer Payment Experience: Opportunities for Payers

A decade ago, the consumer’s role in the healthcare decision-making process was drastically different. Payers and employers managed virtually all of the health benefit decisions for consumers. Consumers were presented with one or two choices for a benefits package, visited the providers in their network and paid a minimal copay, if anything at all. Payment associated with healthcare services generally was not a focal point for consumers.

In recent years, the payment responsibility has shifted (and continues to shift) to the

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Finding Payment Assurance with Smart Big Data

Smart Big Data has the capability to transform the collection process in healthcare. By using Smart Big Data to trigger automated processes and real-time decisions at the staff level in daily operations, providers can collect patient payments efficiently, navigate the changes facing the healthcare industry – and ultimately, to thrive.

Finding Payment Assurance in the Healthcare Industry

When you stay at a hotel, are you able to check in without giving your payment card?  Of course not. However, patients receive access to

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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

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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

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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

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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

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Going Electronic? How to Get Your Providers on Board

In 2020, 26% of surveyed healthcare payers said that more than half of their provider networks still don’t accept ERA/EFT (Trends in Healthcare Payments Annual Report).  Despite the HHS operating rule on EFT standards which went into effect in 2014 and mandated that payers had to adopt ERA/EFT, 84% of surveyed healthcare providers indicated they continue to receive paper checks from one or more payers.

The sooner providers accept electronic payments, the more money payers and providers can save. So how can you

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Enhance the Provider Experience: Deliver Payment Assurance

In an earlier post, we discussed one of the major threats to the payer-provider relationship: the provider’s lack of payment assurance.  This threat poses an opportunity to payers to give their provider networks the tools needed to achieve payment assurance.  In our previous post, we gave tips for payers to deliver payment assurance to their providers.  Below, we’ve included a graphic of the Payment Assurance Framework to demonstrate how payers can deliver payment assurance to providers in each step of the healthcare

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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. 

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