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Posted September 2, 2015

healthcare automation

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The healthcare payments industry faces unique challenges, including an evolving—and highly visible—regulatory compliance environment, as well as fragmented remittance systems and limiting legacy technology. Without the introduction of innovative process solutions, all of these factors can make it difficult for insurance companies and their provider partners to address the cost and quality concerns that are so important in the post-reform era.

The article Tomorrow’s Healthcare Payments, Part 1: Understanding Today’s Limitations provides some context for the changing healthcare payments landscape. Insurers and providers alike are automating their routine manual administrative processes, including claim submission, claim payments, and claim remittance and posting and receiving of payments—and they’re seeing both workflow and financial advantages. (Take a deep dive into this topic by reading the 2013 U.S. Healthcare Efficiency Index report from the Council for Affordable Quality Healthcare.)

Prioritizing Customer Service

The enhanced payment services demanded by patients are helping to drive innovation and change in the B2C arena. Healthcare providers are improving their billing and payment operations to meet their patients’ preferences. They’re becoming more flexible in their ability to accept credit card payments, for instance, and are preparing their offices for meeting future demands as technology inevitably changes. Mobile payments may not be the norm at the doctor’s office check-out window—but only time will tell if a smartphone and scanner are all that’s needed to settle an office visit.

Payors on the B2B payments side can take the cue. Accounting departments can start by identifying the existing pain points in their claim processing workflow and how those impact their suppliers’. Not only does this help develop a business case for experimenting with new forms of payment technology, but it uncovers providers’ needs. Ask questions about their customer/suppliers’ preferences: when and how they want to receive payments? Do they want to continue processing paper checks sent through the mail, or are they moving toward electronic methods? Customers/suppliers may have already expanded their system capabilities and are accepting credit card-based electronic payments, thus providing an opportunity for new tech adoption.

Exploring New Forms of Payments

Electronic payments provide a number of advantages like the potential for real-time payments to optimize cash flow, built-in fraud detection to boost security, and deeper analytics enabling all stakeholders to make better decisions and remain competitive. Plus, they reduce operational costs because they’re less expensive than traditional paper-based methods and yield less errors.

And while the industry is seeing improvements in ACH transaction standards, EFTs, despite their popularity, are not a one-size-fits-all answer to payment automation. Virtual credit cards, which use credit card networks to facilitate funds transfer between payor and provider, are gaining momentum. The two-way nature of virtual payments make funds immediately available for processing and streamline the reconciliation process, especially when managing overpayments.

Learn more about the advantages of virtual payments:
WEX’s Jim Pratt Talks Virtual Cards and Corporate Payments with PYMNTS.com
Promoting Virtual Cards Among Your Suppliers

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