Enabling Hybrid Electronification in Healthcare Payments
According to the 2018 CAQH Index, the utilization of electronic EDI 835 dropped from 56% to 48% from 2017 to 2018, with volume of remittance advice transactions increasing 39%!
Healthcare payments professionals are concerned that this drop in utilization and increase in volume requires a greater share of paper and PDF-originated remittances and payments being processed manually, driving up costs per transaction and creating an inefficient process.
Hybrid Electronification is a viable solution to help RCM companies, clearinghouses, large banks, and healthcare providers to address these issues. The infographic to the right provides a quick glance on the landscape of paper in healthcare, technologies to achieve hybrid electronification and the benefits.
In addition to the infographic, OrboGraph partnered with WEDI to help educate the market by hosting a special free webinar: Enabling Hybrid Electronification in Healthcare Payments and Remits with AI.
The webinar covered topics including:
- Healthcare payment challenges for payer reimbursements
- Vision for full/hybrid/partial electronification
- New technologies involving Artificial Intelligence (AI)
- 3-4 challenges and solutions of dealing with paper and PDF remits
- Provider testimonial and value proposition
Click the buttons below to download the infographic or watch the webinar.
Use Cases for Hybrid Electronification
RCM Company
RCM companies are looking for ways to cut costs, while still providing their client base with products and solutions to streamline their payments processing.
Benefits include:
- RCM company can be like a biller on steroids
- Payments/remits not always offered as services
- Logical extension to product offerings
- As an “outsourcer” to the provider, provider may not care how process are completed
- Can leverage own staff/outside companies overseas
- Existing customer volumes converts to new process
- Looking to be efficient and not add more employees
Clearinghouses
Clearinghouses are eager to expand their offerings, providing a all-encompassing set of solutions and services to their client base.
Benefits include:
- Expanding integrated services beyond claims and into remittance automation
- Changing the lockbox mailing address across providers can be difficult
- Providers can scan paper/upload PDF to cloud
- Customer marketing programs around ABM (account based marketing)
- Marketing, account management and sales expertise
- Technical expertise is strong
Large Banks
Hybrid Electronification is a perfect fit for banks offering lockbox services, as banks are the aggregation points of the paper remits.
Benefits include:
- Expanding treasury management, medical lockbox services with offerings around electronification
- Everything should evolve around the bank lockbox
- Fits the workflow well
- Customer expectations are high so banks need to have a quality deliverable
- Banks many times cannot overcome sales objections
- But many large banks are seeing success as the market understands the need
- Cross sell other bank services into healthcare
- Leverage compensating balances