How to Drive Provider Adoption of Electronic Payments and ReimbursementsLearn how Payspan helps health plans employ innovative provider enrollment best practices to transition their providers from paper checks. Payspan also introduces an innovative solution that leverages existing network connectivity to drive quality care.

www.payspan.com/payers/core/

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Medical and dental health plans are now looking to electronic delivery and its potential for reducing print and mail costs as a method for driving profitability. The costs of manual processes continue to stress medical plans, with $9.4 billion wasted annually on manual processes.1

Most health plans are trying to transition to paperless, yet they are moving at a snail’s pace, still processing more than 50% of their payments manually. They are not alone. It appears that epayment networks have not been able to make a significant dent in enrolling the nearly 1 million providers in the U.S.

In 2017, the epayment adoption rate actually declined from 62% in 2016 to 60% for medical plans, while the electronic remittance adoption rate only increased from 55% to 56%.2 Similarly, dental penetration increased just one percentage point, from 8% to 9%.3

Health plans have indicated to Payspan that they need:

• A plan for transitioning their providers to paperless payments

• A process for enrolling their providers into EFT/ERA transactions

• The ability to offer options for ACH, virtual card and print

electronic payment adoption rates.90%

Payspan has developed a methodology that is already achieving paperless adoption rates from 90%-99% for medical plans. Payspan has recently opened its network and epayment services to dental insurance plans as well. Payspan’s approach applies best practices in provider enrollment, including the offering of multiple electronic delivery options, and guarantees elimination of print and postage costs.

Health plans are moving at a snail’s pace, still processing more than 50% of their payments manually.

Medical

62%

60%

EpaymentAdoption

55% 56

%

RemittanceAdvice

Dental

DentalPenetration

8% 9%

2016 2017

Introduction

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Customized Enrollment Process Makes it Easy for Providers to ParticipatePayspan’s approach is built around a strong provider outreach program that combines email, phone and print outreach strategically designed to make it easy for providers to participate. Payspan works with health plan clients to determine their needs and capabilities and then develops a customized plan.

Payspan provides outreach on behalf of each health plan client to their providers with messaging that is branded to the health plan. Email notifications are easily generated to the health plan’s providers already on Payspan’s epayment network. Payspan also includes providers not on the network if the health plan supplies an email list.

Outreach is conducted in three phases that include progressive calls to action reminding providers to register for electronic payments by a certain date, or they may be automatically enrolled in Virtual Card. Email campaigns include:

• Messages that promote the benefits of EFT/ERA and virtual cards

• Single-click enrollments for single accounts

• The capacity to enroll multiple accounts simultaneously

• Automated registration that enables providers to auto-accept electronic payments from new health plans

• Multiple automated provider communications and self-service registration tools for new providers

• Seamless, integrated online delivery of payments and remittance advice

At the same time, Payspan can take on existing manual processes during the transition at a lower cost than a traditional print vendor.

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If health plans want to get physicians on board, they must find a way to dissolve provider misunderstandings.

More than 60% of the nation’s providers are small practices with 10 or less physicians4, who don’t have the resources to keep up with the latest trends and technologies. Many are skeptical about employing third-party vendors to manage their payments due to misunderstandings about how the process works.

Other obstacles include:

• A lack of understanding of the true benefits of epayments

• Reluctance to share banking information with health plans

• Unfounded fear that health plans have the ability to withdraw funds from provider bank accounts

• A misconception that they cannot manage the process

• Epayment security concerns

If health plans want to get physicians on board, they must find a way to dissolve provider misunderstandings, promote epayment benefits and make sure providers know that they can actually reduce administrative costs, as well as get paid faster.

Health plans also must provide ongoing education and support to help providers successfully transition to paperless payments.

Filling in the Knowledge Gap Key to Provider Participation

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As part of Payspan’s process to shift providers to electronic payments, Payspan offers a comprehensive set of services designed to overcome provider challenges and misconceptions:

• Intensive, ongoing EFT enrollment emails offer a simple and easy registration process while promoting the benefits of being paid via EFT/ERA and virtual cards.

• Each campaign is launched with health plan-branded launch letters that introduce the partnership between Payspan and the health plan.

• Webinars are offered for providers and their staffs to provide training and education on enrollment-related topics.

• Provider services specialists are available daily to assist providers with questions and requests for information. When providers call, they are notified about other health plans on Payspan’s network offering epayment services and guided through the registration process.

• Health plans have access to a portal where they can track and monitor the progress of their email campaigns and provider enrollments.

• Likewise, providers log on to their own portal to access messages from health plans.

Health plans seeking to transition to electronic payments with their providers typically don’t have the time to educate providers about how payment systems benefit revenue cycles. Payspan has built a tool that can take over that task for health plans while achieving top results as shown by our high enrollment rates.

Strong Education & Support Dissolve Obstacles to Provider Adoption

in payments processed annually

$90B

daily provider log-ons to Payspan Portal

40K

client satisfaction

%91implementation net promotor score77.6

claims paid441M

After building the largest healthcare electronic payment and reimbursement network, Payspan saw an opportunity to leverage its network to offer innovative solutions that address additional business challenges for health plans. Payspan’s solutions can help health plans transition to paperless payments, improve member engagement and advance value-based care.

100% Paperless Payments, GuaranteedPayspan’s network connects 600+ health plans with 1.3 million provider payees and 100+ million consumers. This vast reach into the provider world empowers Payspan to offer health plans a 100% paperless guarantee with Payspan’s provider enrollment best practices. Payspan manages health plans’ printing services at a reasonable cost while transitioning them to electronic payments and reimbursements with their providers.

Positive Payment ExperiencesPayspan has developed a member engagement solution that offers patients-members a range of mobile-optimized, digital, and multilingual integrated voice response (IVR) options. By delivering positive payment experiences, health plans can build a gateway to brand loyalty while increasing payment collections.

Value-based Care ReimbursementPayspan leverages the largest epayment network to enable the exchange of meaningful health information between health plans and providers to drive quality care. Instant access to the electronic payment network and easy enrollment break down provider barriers to value-based care and provide a fast, easy way for health plans to pay quality incentives to providers in exchange for proof of care gap closures.

Core Payspan Network Offers Innovative Solutions Beyond Epayments

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Providers are slow to adopt value-based care because they lack resources to interpret and apply complex value contracts.

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A number of health plans have indicated to Payspan that they have gap closure rates in the 3-5% range, which shows that providers are struggling to implement quality measures.

Providers are slow to adopt value-based care because they lack resources to interpret and apply complex value contracts. They need help and guidance to stay on track with applying national standards of care consistently.

Payspan’s secure epayment network can be used to exchange meaningful healthcare data on demand. Payspan’s clients are already communicating with providers about claims and reimbursements via our secure network. Why not use this network to share documents that advance quality care?

New Solution Makes Quality Care PossiblePayspan’s Quality Incentive Communications System (QICS) enables health plans to securely exchange sensitive medical information with their providers via attachments to facilitate value-based care reimbursement. QICS simplifies quality information into easy-to-read, visually appealing formats that practices can act on quickly to drive better health outcomes.

Health plans alert providers about care gaps on demand, share guidance on the quality measures needed to close the care gaps, and offer incentive reports that track and monitor care gap closures and available financial incentives for

closing care gaps. Providers, in turn, share proof of care gap closures to receive their incentives. It’s that simple.

Payspan estimates that this program can increase care gap closure rates from below 10% to 40% or higher. QICS has the power to help health plans build partnerships that result in better member outcomes, lower costs for health plans and increased revenue for both health plans and their providers. Learn more by visiting www.payspan.com/payers/quality-system/.

Epayment Networks a Natural Pipeline for Quality Information

Payspan is the nation’s leading provider of healthcare reimbursement and payment automation services, leveraging the largest healthcare network in the United States to drive value-based care reimbursement, improve the patient experience and reduce costs for payers and providers. Payspan connects more than 600 health plans, 1.3 million provider payees and 100+ million consumers to facilitate alternative payment and reimbursement solutions and the exchange of meaningful healthcare information.

www.payspan.com

Leverage the largest healthcare

epayment network to drive

provider adoption of electronic

payments and value-based care.

Call 844-400-4043,

email salesteam@payspan.com,

and/or

visit www.payspan.com/

payers/core.

1 “2016 CAQH Index Report” 2-3 “2017 CAQH Index Report”

4 American Medical Association, Policy Research Perspectives, “Updated Data on Physician Practice Arrangement: Physician Ownership Drops Below 50 Percent”, 2017