Health Care Payments Technology

by Michael Lichtenberger

Previously, I wrote about current trends in healthcare payments [Network Magazine, Fall 2022.] Whether you collect payments at the time of service or offer a recurring payment plan, your goal remains focused on optimizing revenue and making your patient experiences frictionless through healthcare technology solutions.

Practice managers are looking for payment efficiencies to manage patient obligations as their share of healthcare costs continues to rise, and the ‘patient as payer’ means practices must devote many hours and resources to capturing patient payments, posting and reconciling, managing billing, protecting patient payment data, and reporting. There are many moving parts, and to avoid the practice revenue paradox, the practice management software should be unified with a seamless interface between payments and patient EHRs.

The practice revenue paradox:

∗ 43% of patients desire payment automation.

∗ 44% of patients report being offered a payment plan.

∗ 43% of patients will store payment information with their provider.

∗ 54% of patients want to access EHRs digitally.

But…

∗ 40% of patient obligations are slow-pay, delinquent, or uncollected. [Alite Group]

∗ 20% of all claims are denied for administrative, clinic, or policy coverage.

∗ 60% of returned claims are never resubmitted [AHIMA April 2022.]

∗ 73% of patients decline an offer for a third-party credit card.

In today’s healthcare economy, practice managers balance self-pay arrangements, higher co-payments and deductibles, exceptions to insurance coverage, and claims rejection and denial – all of which impact the patients’ experience. Patients want online scheduling and appointment reminders, waitlist management, and a suite of tools for educating patients. They seek convenience with text-to-pay and QR codes to initiate payments, and 80% of patients prefer using digital channels to pay their healthcare bills.

Payments-as-a-service [PaaS] is embedded in many practice management platforms. This module is often required for integrating payments with EHRs. Many healthcare providers have expressed frustration by adopting their vendor’s sole option. Practices are paying 6% or more for their cost of acceptance. Practice managers believe that since their vendor is their only option, they must accept their costs. For control and access to practice revenue, some prefer to keep payments external but with duplicate data entry – one to accept payments, the other to post the transaction to the patient billing record. We know this is not the case, and there are alternatives, including payment management that works with any practice management software.

Today’s advanced practices are demanding more control over their revenue and now want to source a more cost-effective end-to-end healthcare platform that optimizes technology to see better outcomes.

Practice management platforms also focus on compliance training and documentation. No practice should tackle HIPAA requirements alone, and best-in-class solutions provide strategies for compliance. Likewise, the Payment Care Industry [PCI] Data Security Standards [DSS] continue to evolve and become more complex. HIPAA and PCI DSS modules secure and protect patient data.

Of course, in addition to payment technology, HIPAA, PCI DSS, OSHA, and patient experiences all combine to overwhelm the staff with even the best-organized practice. Because automation can touch many parts of a practice, there are different types of benefits and ROI.

Technology utilization can also reduce administrative expenses. A Stanford University study reported that the rate of increase in administrative costs had outpaced that of overall healthcare expenditures. By automating tasks like billing and patient payment capture, your practice can see an increase in efficiency that can also increase cash flow. Some parts of your practice likely employ automated processes, and nearly 78% of healthcare systems are currently automating their revenue cycle operations.

Automatic payment posting frees up staff time and can now be assigned to the overall patient experience. With universal compatibility with practice management platforms, payments are posted to the ledger without manually and repeatedly entering data.

Practices can create a friction-free payment model by giving patients multiple ways to pay. Whether in-person, online, pay-by-text, or QR codes, there is flexibility with financing options for a positive payment journey. Payments-as-a-service allow patients and providers a look at data in real-time.

PaaS benefits are healthcare specific and have four components: cash flow, convenience, cybersecurity, and collaboration. What does this all mean to your practice?

Cash Flow – reliably capturing payments to decrease days in accounts receivable. A positive cash flow makes it easier to prioritize day-to-day operations.

Convenience – technology makes achieving your goals possible. And patients that utilize digital registration can submit health histories, current medical status, insurance information, and payment preferences.

Cybersecurity – healthcare organizations often find themselves targeted by malicious activity. SaaS and PaaS solutions that comply with HIPAA, EMV, and PCI secure sensitive patient information.

Collaboration – occurs between providers, staff, patients, and payers for a seamless experience. While many practices utilize electronic health records to keep track of patient information, SaaS solutions that interface with these records can reduce duplicate work and improve administrative efficiency.

Your selection of a payment solution can make the difference between data protection and a breach.

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