“While federal health reform is poised to drive the adoption of electronic payments and remittance, investments in the technology already are increasing, offering payers incremental improvements in efficiency and cost-effectiveness, and laying a solid foundation for the future,” said PayStream Advisors’ Managing Director Henry Ijams.
Eliminating paper payments and remittances from the healthcare revenue cycle could save the industry tens of billions of dollars over the next 10 years, the PayStream report states. In fact, moving to a completely electronic claims payments system could save the industry over $30 billion a year, according to the U.S. Healthcare Efficiency Index (USHEI). Just eliminating paper checks in healthcare and moving to EFT could save $11 billion a year, USHEI estimates.
The PayStream Advisors report notes that a number of factors have stymied adoption of EFTs and ERAs, including weak industry standards, resource constraints, the limitations of legacy systems and processes, and shifting priorities, such as ICD-10 conversion. But EFT/ERA adoption is about to get a shot in the arm as a result of payer mandates contained in the federal health reform legislation.
“Despite the seismic changes shaping the healthcare industry, the end-game with electronic claims reimbursement remains unchanged: straight-through processing (STP) enabled by payers sending electronic remittances along with an electronic payment, which can be reconciled and automatically posted to the provider’s patient management system,” added Ijams.
The 33-page report provides payers with a comprehensive roadmap for EFT and ERA adoption, covering topics such as: building a business case for EFT and ERAs, key barriers to adoption, critical technology and business process considerations, and tips for selecting a vendor.
The PayStream Advisors report also includes detailed profiles of four leading providers of claims reimbursement solutions and services.
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