INTRODUCTION
Healthcare payment processing has changed significantly this decade as the complexity of processing payments has grown. At the same time, the technology for automating that process has evolved, with solutions available not only from certain specialty software vendors, but also from a surprising source: the banking industry.

Full payment processing automation is fundamentally about getting a practice’s money in the bank as quickly as possible. Therefore, it makes great sense to use a bank.

A LOOK BACK
Looking back just a few years, the progress made in automating payments processing is easy to see. Even with the release of the ANSI 835 format in 1991, as recently as five years ago the vast majority of payments and EOBs were still on paper. This meant the cash flow for most providers in 2004 was still very paper-bound.

Some banks evolved their lockbox offerings to scan and index client documents, a major step forward in streamlining the back office. The value proposition of turning paper into a searchable, electronic format was compelling: save time and make more money. Time savings came from productivity gains and the profit boost came from gaining faster access to cash. However, while scanning paper and storing it online was a step forward, most of these solutions did not provide integration with Practice Management Systems. The back office staff still had to post payments manually.

THE NEXT STEP
Even with this electronic processing of payments and EOBs, providers today still receive a mix of paper and electronic payments and documents. This means that most practices don’t yet realize the promise of automatic posting. Practice Management Systems that accept 835s can provide the benefits associated with automatic posting. However, paper EOBs keep providers from reaching auto-posting nirvana. Furthermore, reconciling payments to EOBs remains complex due to the multiple formats in which they are received. Help for providers exists in the form of current generation healthcare payment processing solutions that far exceed their digital lockbox predecessors in terms of capabilities.

WHAT TO EXPECT
New solutions for automating healthcare payment processing promise to help providers achieve the highest rate of autoposting possible while providing other valuable benefits. These solutions aggregate all payments and EOBs regardless of the format in which they are received. The reconciliation process becomes automated. Secondary billing, denied claims and underpayments are likewise detected automatically and presented to the provider for action. Most importantly, a single electronic file is output that feeds Practice Management Systems to facilitate autoposting.

It is appropriate to set an expectation about these solutions. Achieving a 100 percent auto-posting rate is not always obtainable, but a premier solution can offer rates as high as 95 percent. Furthermore, the degree of integration difficulty varies with every Practice Management System.

HIDDEN BENEFITS
Eliminating manual posting is a major benefit to today’s revenue cycle management solutions, but it is easy to overlook other major benefits. Imagine searching all of your payment information, regardless of whether it came on paper or electronically. That capability is now a reality. Access to data is greatly simplified because all payment data is aggregated into one electronic repository, making on-the-fly research easier and less time-consuming.

Other benefits exist as well. Physical document handling is eliminated, so time is not wasted on filing. The exceptions handling process is expedited. These individual productivity benefits combined form one large, compelling benefit: a reallocation of staff away from document handling tasks to full payment recovery.

THE RETURN
The return on investment (ROI) in healthcare payment automation is also compelling. An accurate ROI estimate is developed by looking at the candidate tasks for automation, then applying some assumptions which the following example illustrates:

Using these productivity assumptions, the 25 hours spent daily on these four tasks is reduced to 6.2 hours, for a savings of 18.8 hours. Multiply the hours saved by your hourly average staff salary with benefits. For the sake of this example, assume a loaded salary figure of $20 per hour. The value of productivity in this example becomes $376 per day or close to $7,800 each month. This estimate does not include the additional benefit of freeing staff time to pursue full payment recovery.

SUMMARYK
SNB offers the SNB DirectRemit MD healthcare payment management solution to help providers save time and money on a whole new level. Various industry estimates in recent years reveal that as much as 30 percent of every healthcare dollar goes to defray paperwork and administrative costs. SNB DirectRemit MD will drive this figure lower, to the benefit of payers, providers, billers and patients alike. For more information or to schedule a demonstration, please visit: www.banksnb.com/directremitmd.