How healthcare providers can optimize patient payment processing systems to not only meet ACA regulations, but to meet the needs of their consumers.
With High Deductible Health Plans (HDHPs) and out-of-pocket payments on the rise, healthcare providers need to review and examine their patient payment processing systems. While every case is different, there are some common questions asked and themes that arise with a thorough review of a payment process.
You can't build a roadmap without first charting where you are. A basic review can be broken down into quantitative and qualitative parts.
Begin with an analysis of performance metrics—such as financial performance, operational efficiencies, etc.—as well as an overview of payment outlets, types, systems and workflows. Another critical step is looking into your processes analytics capabilities. Is your data as accurate as can be? Finally, ensure that your processes are compliant with regulation.
While providers may process many payment types via many payment outlets, it is important to identify those which function sub-optimally, relative to performance metrics. The qualitative evaluation can include assessment of slow A/R days, high processing costs, or a high amount of people-time to post.
Set individual goals for future performance with specific metrics revolving around financials, operations, reporting, analytics and compliance. Develop a timeline for improving specific payment outlets and activating specific payment types. Give you and your team realistic benchmarks with reasonable deadlines.
Identify a process for evaluating third party vendors of services and solutions required to build out payment outlets, plug payment gaps, improve reporting and drive compliance. Address qualitative and quantitative performance by payment type and outlet.
Most importantly, keep evaluating processes and goals. Ensure you're up to date with the latest technology and regulatory issues, which are constantly changing. Maintain current metrics and schedule regular touch points to ensure you're on track to reach your objectives.
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1 AHIP Center for Policy and Research, 2005-2011 HSA/HDHP Census Reports; June 2011 report, p. 2