Will Your Payment Solutions Be Ready for the Affordable Care Act?

The Patient Protection and Affordable Care Act, also known as Obamacare, has been ruled constitutional by the Supreme Court of the United States. Even if the President loses the upcoming election, it is unlikely that the country will allow for the repeal of this new healthcare law. Under the law, as many as 35 million uninsured Americans will join the millions of those who do have health insurance. This means that insurance companies and healthcare providers of every kind and size will have to deal with great numbers of the newly insured.

While the affects of the Affordable Care Act on healthcare providers is still uncertain, according to a recent survey, 55% of healthcare providers predict a drop in revenue. With a potential drop in revenue and increase in insured patients, the amount of paperwork needed for each patient will be on the rise and an efficient workflow will be more important than ever to keep up. One thing is certain, if you are not currently utilizing automated Explanation of Benefits (EOB) posting and reconciliation, your accounting functions will be challenged by increased patients and possibly new insurance products. Keeping up with the current payment workflow is a nearly impossible task but with line item posting of Electronic Remittance Advices (ERA) reconciled to EOBs automatically, staff will quickly see exception reports and be able to respond to them quickly.

At the recent 2012 ANI: The HFMA National Institute conference held in Las Vegas, many discussions evolved around using new revenue cycle management (RCM) technology to expedite postings of ERAs and EOBs. Today’s solutions are scalable so any virtually any solo practice or large hospital enterprise can benefit by using the latest technology. These new RCM solutions are easily integrated with local or hosted practice management systems (PMS) and even accessed through “the cloud”. HIPAA privacy considerations have been a challenge to cloud based solutions but many companies have created “private” clouds that are secure, scalable and affordable – a constant theme on the list of wants by healthcare providers.

Providers already struggle to keep expenses down and new RCM technology can help achieve this goal by reducing data entry labor expenses, lowering errors, speeding up posting and getting payments into the bank as quickly as possible.

A sea of change is coming in healthcare payment processing. Maximize your facility’s capabilities and gear up with appropriate software to shorten your revenue cycles.