Resources / How to Modernize the Payer Provider Experience Podcast: The Highlights
IDR Podcast: The Highlights
Kaitlin Howard

By Kaitlin Howard

Kaitlin Howard is a researcher and writer producing insightful content across the healthcare revenue cycle. She has written and produced content for Zelis, Waystar, and Recondo Technology, as well as agencies. With a B.A. in English and Writing from University of Denver, Kaitlin stays current on market updates on claims management and healthcare payments, publishing a regular educational blog series on industry trends and Zelis offerings.


Manual claim payments create friction. And that’s only made worse when payers couple manual payments with other forms of paper-based communications. 

In the second part of our payer/provider series, Zelis Director of Business Solutions Leah Silver joins Brian Zimmerman with Becker’s Hospital Review to discuss innovating and modernizing the payer provider experience. 

We’ll discuss the highlights below, but you can listen to the full podcast here:

How has the digitization of the payer provider experience affected different dynamics?

Members

In the past, simply from a digitization perspective, the member has been left out of the mix. When you typically imagine their experience, it often boils down to one thing: communication. But that’s not the problem. The real challenge, rather, is that these communication methods are primarily paper-based and lacking at best.

 Let’s set the scene.

You receive an Explanation of Benefits (EOB) in the mail. 

We’ve all been there. Standing in the kitchen, grocery bag in one hand, as you attempt to read the fine print of an already stressful letter. You sigh as you realize, yet again, you have no idea what it is you’re reading. 

Digitizing the member experience can help. Providing the information consumers are actually searching for with the touch of a button is essential to member experience. No one (or, shall we say, only a select few) wants to open up a piece of paper through the mail that arrived days after their appointment. Society is digital. We like texts. We like email. We like notifications that tell us when information is available. And we like it in real-time.

Providers

When thinking about how to create streamlined efficiency for the provider as it relates to payment digitization, it comes down to a shift in the dynamics between the payer provider experience. 

As always, the end user has to be in mind. And that end user wants seamless technological advancement that fits into their everyday life. 

Providers need to look at ways in which they can adapt and implement technology, but they also need to look at it in a more human way.

Payers

Payers are the connective tissue responsible for providing the connection and support necessary to keep everything functioning. As such, consumers are looking to payers to adopt technology advancements on par with current times. 

In order to retain membership, payers must look to integrate digital innovative technology with their traditional operational processes to ensure provider and member satisfaction. 

But it’s also important to think about the human component. 

Payers must look at day-to-day operations from not only a business standpoint but also a personal perspective. 

What is the importance of electronic communications in healthcare today? 

Bottom line: People hate paper. Consumers want actionable steps, and they want them in the palm of their hand. 

By digitizing communications, your organization guarantees a solution preferable to the end user. 

From a provider’s perspective, digitizing the consumer experience takes the manual workload out of reconciling payment and claim data. Which means you can finally realize the healthcare industry’s main goal: standardizing processes to allow providers to automatically reassociate claim information and payment data in real time, without the typical administrative burden. 

The Wrap Up

The healthcare industry is notorious for being a few steps behind. That stops now. 

Organizations must do their best to advance current technologies and integrate the innovative tools we have available to digitally empower providers, payers, and consumers.

If you’re interested in finding out how Zelis can help you digitize, click here

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