4 Questions Payers Need to Ask About Their Employer Groups

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Employer groups make up a large portion of the covered lives in the healthcare industry. For this reason, employer groups are an important segment of a payer’s business. To stay competitive with employers, payers often develop more attractive offerings with benefits packages that include health, dental, wellness and vision plans.

The billing process for these plan premiums are often not part of the strategy to

Tagged Employer Groups, payers

The Hidden Potential of BYOD and Provider Check-In to Transform Member Engagement

In 2017, U.S. healthcare spending reached nearly $3.5 trillion, or $10,348 per consumer, at a projected growth rate of 4.6 percent. Healthcare spending has become nearly a fifth of the nation’s total Gross Domestic Product (Centers for Medicare & Medicaid Services). This steady growth and large size of the industry make it a major economic driver for the country.

Whether the industry can sustain this size and growth are questions that remain unanswered. The answers, and thereby the future of the

Tagged Check-in, Engage, payers, trends in healthcare payments

Payer Security Focus: Anti-Money Laundering

Every month, the Payer Security Focus breaks down a different topic in security and compliance with information relevant to payers and actionable steps to help build a more robust security and compliance program at their organizations. This month’s topic is anti-money laundering.

What Is Anti-Money Laundering (AML)?
Money laundering is the process of turning “dirty money” or the profits from a crime into legitimate money. This is primarily done through incorporating illegal funds into the financial system in such a way that

Tagged Anti-Money Laundering, payers

Payer Security Focus: Compliance Versus Security

Every month, the Payer Security Focus will break down a different topic in security and compliance with information relevant to payers and actionable steps to help build a more robust security and compliance program at their organizations. This month’s topic is compliance versus security.

What is the Difference Between Compliance and Security?
To understand the importance of compliance and security in healthcare payments, first let’s clarify the difference between the terms compliance and security. Both are important to healthcare payments, but these

Tagged healthcare payment security, payers, Payment security, PCI compliance

Payer Security Focus: PCI DSS

What is PCI?
PCI DSS stands for Payment Card Industry Data Security Standards and applies to all entities involved in payment card processing, including merchants, processors, financial institutions and service providers. It also applies to all other entities that

Tagged payers, PCI-DSS, Security and compliance

How Much Is a Consolidated Premium Experience Worth?

To stay competitive, payers are developing more comprehensive benefits packages that include health, dental, wellness and vision plans for more attractive offerings. However, billing for these different plans means coordinating disparate systems and varied employer group billing preferences.

To bill employer groups, payers send out multiple paper statements to collect payments across all of the plans and members – each managed separately by the employer group. For the individual market, members may receive separate bills for each plan with different payment

Tagged Employer Groups, payers, premium payments

Where’s the Money? Current and Future State of Healthcare Payments for Payers

The concept of health insurance in the U.S. first started during the Great Depression when Baylor University Hospital in Texas offered teachers the benefit of prepaid hospital expenses for a $5 per month fee. However, it wasn’t until World War II that health insurance became a widespread benefit offered by employers. WWII forced employers to rely on “fringe benefits” like health insurance to attract more workers to meet the higher demand for resources to help fight the war, while food

Tagged healthcare payments, payers

Are Payers Part of Healthcare’s Paper Problem?

Healthcare is one of the last industries where most information is primarily transmitted via paper, including EOPs, EOBs, mailed paper statements and paper check payments. Overall, the ability to support these paper-based transactions requires manual processes that cost payers significant resources – consider that 16 percent of total healthcare spending is on administrative costs. .

Going paperless is a challenge for organizations of all sizes and types, requiring them to invest in new technology, change workflows, retrain employees – and the

Tagged paperless, payers

Payer Security Focus: Preventing Ransomware in Healthcare

Ransomware is a type of malicious cyberattack that has grown in notoriety and frequency in recent years. Like kidnapping, ransomware works by taking something valuable to an organization – such as data files – and holding it hostage until a ransom is paid.

Ransomware infiltrates an organization’s system by infecting someone’s computer with a virus, which is likely accomplished by tricking that person into clicking a link or downloading a file in a phishing email. These emails are disguised as a

Tagged payers, ransomware, Security and compliance

Blog Post Topic: payers