The healthcare industry is estimated to waste $750 billion a year. One of the many areas of unnecessary expenditure and inefficiency is the current payer to provider payment system. Even in the era of instant person-to-person payments, healthcare providers and payers are using antiquated payment methods. These include paper checks that are expensive and slow, and ACH payments that although are electronic, are limited in the amount of data that can travel with the payment.
The Current Healthcare Payment Landscape
Payments in healthcare aren’t simple. When payment for a service is made to a provider, the provider sends a complex claim with EMR data to insurance or government agencies (payers). These agencies then adjudicate claims to determine which parts of a claim to accept and which parts to decline. This is where the problems begin.
Payments arrive too slowly. Insurance and government organizations use a system, like paper checks and automated clearing houses (ACH), to pay providers. Whether payments are made by check or clearinghouse, they take far too long to arrive to the providers.
Payments are unnecessarily expensive. By using this system, even payers suffer. Payers incur costs to manage the printing and mailing of checks or are stuck paying fees to send money via ACH. Additionally, ACH pricing models are typically set by the bank and are often inflexible; each separate payment costs a fixed amount, with no options for flexible monthly or yearly payment schedules.
Payments lack context. When payments finally arrive at providers, detailed claim information—multiple line items, various codes, attending physician details—is not attached. Only patient and incident names are included with payments, causing staff to spend time reconciling to electronic remittance files that are sent separately. Then, the team has to investigate why payments were not paid in full. It takes a lot of time and effort to identify rejected claims and resubmit payment requests. In many organizations, this step is seen as too costly to tackle and often is not pursued at all.
Even though healthcare payments are slow, expensive, and contextless, there have been no comprehensive attempts to fix the system.
What A Modern Healthcare Payment System Looks Like
Given the clear-cut problems of current healthcare payments, it’s easy to imagine what an updated system should look like.
Payments are made in real time. If the average person can instantaneously send a payment to a friend through an app, there is no reason why professionals in the healthcare industry cannot do the same thing. All payments should be able to go from payer to provider in real time—and be trackable through the entire process.
Payments are cost-effective. Healthcare payments should not be expensive. Healthcare payment systems should charge a low-cost per-payment fee or flexible monthly or yearly plans.
Payments are transparent. Most importantly, healthcare payments should be transparent. Payments should include clear, detailed context so that healthcare providers do not need to waste precious time figuring out the cause for a payment. If we can Venmo our best friends money and add a note saying that it is for “last night’s pizza” there is no reason that the healthcare industry should not be able to add detailed context to payments, too.
This is a clear vision of healthcare payments’ updated future: fast, cost-effective, and transparent.
What To Look For In A Solution
When looking for a solution, there is no reason to settle. Any healthcare payment system in this era should have the traits we have explored, as well as a few others.
Traits you absolutely must insist on include:
- Speed: Any payment system in the market should be able to process payments within 24 hours at most while providing comprehensive tracking abilities.
- Cost-effectiveness: While per-payment charging should be an option, it should be far cheaper than the current ACH models. Your solution should also offer flexible payments, which charge based on a monthly or yearly basis.
- Transparency: Most importantly, you should be able to see exactly what your payment is for, down to the line item and percent paid.
- Security: You should be able to send your payments with guaranteed HIPAA and bank-grade security. New technology should provide transactions just as secure as ACH transactions.
That’s where AmplaPay comes in. Our solution offers speed, cost-effectiveness, transparency, and security. While most solutions out there offer some of these features, we pride ourselves on focusing on payment transparency more than other brands. We can ensure that your payments will link with EMR data and arrive with complete context so that healthcare providers no longer have to waste valuable time searching for claim information to match with payments.
Our frictionless, secure, and transparent platform saves everyone money in the end—especially the patients themselves. Interested in becoming a pioneer of the payment revolution? Talk to us today.