Claim Payments & Communications: Your Optimization Blueprint

Discover the insights to optimize your payments and communications while solving your biggest pain points.

While last year had many challenges, it also catapulted the evolution of healthcare payments and communications. From lower claim volume to a drop in member satisfaction with communications, the industry  with unprecedented obstacles that forced it to adapt.

Payers need to find a better way to reduce costs and keep members and providers happy. Members are confused by the large volume of transactional claim communications and want to better understand what they owe. That’s why we created our free eBook: “Claim Payments & Communications: Your Optimization Blueprint.” Discover the insights to optimize your payments and communications while solving your biggest pain points.

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Here’s what you’ll learn:

Driving Savings and Simplicity

The pandemic has fundamentally changed how providers think when it comes to getting paid. Keeping safe from COVID-19 has taken precedence over everything else. People are taking much more precaution when going about their daily activities.

Staff aren’t too keen on getting checks delivered in the mail or taking them to the bank for processing anymore. There’s simply too much unnecessary risk of exposure.

Also, the average cost of processing a paper check is approximately $6. When you think of how many checks you’re sending to your providers annually, the cost really adds up.

By switching to electronic payments, the medical and dental industries could save a combined $898M annually.

Ditching checks reduces costs for both payers and providers, helps protect staff and also has less negative environmental impact. For all these reasons, the medical industry has experienced a steady rise in adoption. This past year has made it clear that payers and providers need a different solution to help them adapt to the impacts they’re facing today.

How to Optimize Your Payments and Communications

In today’s complex healthcare payments and communications landscape, there are multiple factors putting stress on your bottom line. With lower claim volume, payers have had to pay large rebates to customers due to MLR (Medical Loss Ratio) requirements. The increase in laid off and furloughed employees has resulted in a membership transition from commercial plans to Medicaid and self-pay. With all these obstacles, payers are facing an uphill battle in trying to generate revenue.

By converting your providers to direct deposit, you eliminate manual processes and workarounds for all parties. Your providers won’t have to come into the office or go to the bank just to get paid. Keep your costs at bay and providers happy with electronic payments. And it’s completely contactless. No touch – no problem.

Traditional communications were not designed to communicate the complexities of financial healthcare transactions, and to meet state and federal compliance requirements. With Episodic EOBs®, we consolidate your transactional claim communications and deliver them in the preferred way. By switching up the frequency, you can reduce claim communications volume and costs.

How to Improve Member and Provider Satisfaction

Sometimes it can feel like a tall order trying to keep your members and providers satisfied. Delivering a variety of monthly communications to a large network is a costly and complex process that can cause confusion for members.

When you multiply each member’s episodes of care by a large network, it comes out to tens of thousands of communications per month. The biggest challenge for your members is making sense of it all and understanding exactly what they owe.

A provider sends the same bill to a member for service an average of 2.9 times. (Source: Bain & Co,)

By reducing touchpoints and consolidating mailings, members feel less inundated by transactional communications, improving their satisfaction.

Providers want choices when it comes to getting paid. There’s not a one-size-fits all solution that can be applied. By offering both Zelis ACH and Virtual Card, providers get piece of mind that they are in control of their payments. By speeding up their access to cash and reducing the burdensome manual processes associated with processing paper checks, we keep your happy.

How to Close the Gaps in Electronic Payments and Communications

With such complexity still existing in healthcare payments and communications, how can I deliver payments and communications better? We’re sure this question has been on your mind. By using this step-by-step guide, you’ll have all the answers you’ve been searching for.

Whether you’re a small TPA or a large health plan, everyone needs to find the solution that works best for their specific needs. Having several options for delivering payments and communications makes thing easier all around.

By converting your providers to Zelis ACH, you can realize huge gains in efficiency and savings. Stop slowing down the payments and optimize your processes with electronic payments. Providers get their funds delivered weeks faster than mailed checks, increasing satisfaction. Not only does it save time, but also improves efficiency and drive savings. Delivering claim payments is no easy task, especially on a large scale.

By converting your communications to Episodic EOBs®, you can consolidate claim communications, reducing costs. When members receive clearer less frequent communications, they feel less overwhelmed, improving satisfaction.

There’s no way to know what may come, this blueprint will help serve as a roadmap to success. The challenges you’re facing are complex require customized solutions to help you overcome them.
Forget about the roadblocks of the past. With this eBook, you have the tools and expertise to forge ahead. Zelis can help you every step of the way.

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