Simplify the payment process.
Simplify the payment process.

NAVIGATING
THE ELECTRONIC PAYMENT PROCESS

Distributing and managing claim payments in the constantly evolving healthcare landscape is incredibly complex. You already know the challenges at each payment stage. But did you know you have a partner to help you along the way?
Follow the payment process, and learn what you need to navigate the shifting payment landscape with ease.

Provider Enrollment

Welcome to enrollment, the first stage of the payment process. The enrollment stage is when a provider enrolls with a health plan to receive specific electronic payment types.
Welcome to enrollment, the first stage of the payment process. The enrollment stage is when a provider enrolls with a health plan to receive specific electronic payment types.

The Challenge:

The enrollment process can be long and tedious for providers. It takes time for enrollment personnel to process the forms and appropriately set up a provider's account.

The Kaiser Family Foundation estimates that U.S. physicians spend up to $31 billion each year on business-related communications with health plans.1

The Challenge

The enrollment process can be long and tedious for providers. It takes time for enrollment personnel to process the forms and appropriately set up a provider's account.

What You Need:

Meaningful Insights
You need to be getting insights on your provider and member behavior right from the beginning.

Electronic and Automated Processes
Automate previously manual processes to reduce human error and administrative costs.

What You Need:

Meaningful Insights
You need to be getting insights on your provider and member behavior right from the beginning.

Electronic and Automated Processes
Automate previously manual processes to reduce human error and administrative costs.

Determine
Payment Distribution

Now, it’s time to navigate a provider’s payment distribution preferences.
Some providers prefer ACH; others would rather use Virtual Card.
Now, it’s time to navigate a provider’s payment distribution preferences. Some providers prefer ACH; others would rather use Virtual Card.
Now, it’s time to navigate a provider’s payment distribution preferences.
Some providers prefer ACH, others would rather use Virtual Card.
Now, it’s time to navigate a provider’s payment distribution preferences. Some providers prefer ACH, others would rather use Virtual Card.

The Challenge:

Most providers have different payment method preferences. Keeping track of a provider’s preferences is challenging. Offering only certain electronic payment methods can reduce provider adoption.

Improve provider adoption. Give providers and consumers multiple payment options.

What You Need:

Meaningful Insights

A solution that automatically determines the most efficient payment type and distribution route based on provider and payer preferences.

Multiple Payment Distribution Options

You need a partner that can provide multiple distribution options, so you can customize your payment distribution based on your providers’ preferences.

What You Need:

Meaningful Insights

A solution that automatically determines the most efficient payment type and distribution route based on provider and payer preferences.

Multiple Payment Distribution Options

You need a partner that can provide multiple distribution options, so you can customize your payment distribution based on your providers’ preferences.

Accurately Distribute
Each Payment

After you’ve determined your best payment distribution option, you collect funds and distribute payments.

The Challenge:

Managing multiple funding sources can be a challenge. You need the right control processes to distribute and reconcile each payment appropriately.

Transitioning from manual claim submission, eligibility and verification, prior authorization, claim status inquiry, claim payment, and remittance advice to electronic processes could save health plans up to $1.7 billion.2

What You Need:

Automated and Consolidated Processes

This can help you gather insights and create clarity around disbursements. It can also help you reduce costs associated with distribution, reconciliation, remittance data, and reporting.

Simplicity

Simplify your operational processes. Look for a payment system that can consolidate all of your funding drawdowns, settlements, and reporting.

Reconcile Payment

Congratulations, you’ve made it to the end of the payment process. It’s time to reconcile payments.

The Challenge:

Managing multiple funding sources can be a challenge. You need the right control processes to distribute and reconcile each payment appropriately.

The average payer spends approximately $2.09 on claim payments. Automating this process reduces the cost to $1.05 per claim.3

What You Need:

Automated Processes
You need a partner that can automate and streamline processes. This helps you reduce costs and ensures you get paid faster.