Healthcare Payments Market Opens New Opportunities for Financial Institutions

Healthcare payments may be one of the fasting growing segments of the business community, creating significant market opportunities for financial institutions — if they partner with Healthcare Providers to help them overcome the challenges they face.

Chief among these obstacles is helping Healthcare Providers understand how they can leverage new technology to implement electronic payments and automate manual processes. Ultimately, streamlining the revenue cycle process will minimize exceptions and reduce overall processing costs for the provider.

According to the Electronic Transaction Savings Opportunities for Physician Practices, Milliman USA, June 11, 2006, a physician who currently relies on paper and telephone calls for insurance administration may be able to save more than $42,000 a year through simple steps to increase electronic transactions for operations likes claims submission, referral and preauthorization requests, and eligibility verifications.

* Source: Electronic Transaction Savings Opportunities for Physician Practices

In addition to per-transaction financial savings, Milliman identified other benefits, which although hard to quantify, are no less substantial:

  • Electronic claims submissions minimize exceptions and the need to resubmit claims multiple times
  • Electronic claims submissions improve cash flow and reduce accounts receivable days
  • Electronic transactions reduce back-office costs
  • Electronic options enhance scalable growth

Patients are also continuing the shift to online payment channels, i.e., biller direct and bank bill pay solutions, a trend expected to continue through 2017. Online payments make up approximately 50 percent of bill payment volume, while check payments lag behind at just 23 percent.

Help Providers Enhance their Revenue Cycle

Yet, despite the clear cost savings and shift to online bill payment, providers can find the switch from paper to electronic daunting.

Consider these expert tips when working with providers:

Start with Paper: Help providers identify systems that move information from paper to electronic, looking for configurable file outputs that meet provider system requirements. Look for obvious advantages and ease of use.

Understand the Provider’s Needs: Avoid making assumptions. Ask questions to clarify. Keep in mind that cookie-cutter solutions may cost more and fail to address individual provider needs. Act to address their unique concerns and business objectives.

Remember Reporting and Analytics: To detect partial payment and reporting and identify trends in volume, providers need detailed reporting. Help them identify options that will meet their needs or work with them to customize analytics.

Think Broadly: When working with providers consider the end-to-end process—top down and bottom up. Help them minimize exception processing and implement business rules to be more effective. Look for ways to reduce costs, speed implementation, and simplify reconciliation.

In addition, be sure you understand the risk of offering solutions to Healthcare Providers, ensuring your approach is in line with your organization’s risk tolerance and putting procedures and policies in place to mitigate risk.

Healthcare payments offer new opportunities for unprecedented growth. To maximize business opportunities, don’t wait for providers to come to you. Take the initiative and forge new partnerships with Healthcare Providers to make this a win-win situation for all.