In our latest Treasury Services Expert Conversation, we focused on the level of paper processing that still occurs in healthcare receivables processing, and what options providers have to reduce it. Valerie Rodgers is a Healthcare Product Manager with BNY Mellon. Bruce Hallowell is Managing Director for Healthcare with Navigant.

Why is there still so much paper involved in healthcare receivables processing?

Hallowell: It's a funny issue. Everybody predicted checks would go away. In reality, it happened only to a certain level--25% of all transactions still use checks. With healthcare remittances from auto accidents or workers comp, we have payers in healthcare that still have to pay health care claims but it's not their core business. They're not going to convert. It's too expensive for them. Then you have a layer of mid-tier and smaller providers that won't make the investment in the technology either. It's no different than retail banking. People still write checks. Companies love checks, too. It's easier to manage the books, especially for mid-tier and self-funded providers.

Rodgers: Agreed. Going digital means making investments in new technologies, which may be a limiting factor for providers in today's cost-constrained environments. Migrating from paper based processes also requires changes in workflow and commitment to additional training. In addition, the enrollment process for receiving electronic items from payers can be cumbersome and may require dedicated resources to manage.

What are the challenges of having this lingering paper in the system?

Rodgers: Paper is still very manual and resource intensive which drives up administrative costs and delays the posting process. This is particularly true with denials in correspondence because the research is cumbersome and it causes a delay in taking action and submitting any necessary secondary claims.

There is also the security risk and the risk of losing information. By having all information in one, easily accessible digital platform, it makes it easier to have a truly integrated care team. Without all the data in one place, it's difficult to cover the patient from an end-to-end perspective.

Hallowell: And if providers can't combine paper and ACH and patient payments with my electronic payments into a single platform, they can't interrogate the data efficiently, and that's why this whole electronic migration effort is important. Within the revenue cycle, providers produce bills and predict what they're going to be paid, but the only place where the rubber hits the road is in remittance data because it's the only thing that's been accepted and processed.

With fragmented data, providers don't have a true electronic actionable data set, and they are always making decisions on incomplete information. They can't take actions against problems within the process or fix them. With margins in healthcare getting smaller, they can't afford not to have the true picture.

What are the options for reducing the level of paper processing?

Rodgers: The only way to achieve a fully electronic solution is using a combination of technologies that can deliver high automated straight-through posting rates, whether it be receiving 835 files directly from payers or through clearinghouses or converting paper documents to electronic equivalents.

Figuring out the appropriate technologies and strategic partners who will help move a provider to a 'paperless' environment is key. Look for partners who can offer clearinghouse services to migrate as much paper to electronic as possible but also have solutions to manage the remaining paper such as paper to 835 conversion for both EOBs and correspondence, reassociation services, as well as solutions to reduce paper in the denial management process.

Keep in mind we should focus on the patient side as well. Some providers have not established patient portals to enable online payments. Shifting to a portal based solution would help with some of the paper processing fees such as sending paper statements and receiving paper checks. More and more patients are seeking flexible payment options such as online and mobile so I am hoping this causes a shift away from paper based billing and payments.

What is the role of a banking partner within this overall payment ecosystem?

Rodgers: As banks, we have a unique view of various data sources. We can see what's coming in as far as receivables (remittances and payments) and we also have a view into payables as well. It all rolls up to treasury and cash management functions, and having this view enables greater transparency when making decisions.

Hallowell: There are incredible cost savings that can be achieved by converting to electronic. For example, a CAQH report found that for remittance advices alone there's a $3.7 billion cost savings opportunity. It also finds claim payments only at 60% electronification and remittances at 56% which shows there is still a lot of work to do. The banks can play a pivotal role in working with the healthcare industry to achieve this.

What practical things can and should providers be doing now?

Hallowell: Providers need to leverage the data that they have. Again, the only true data is claims data. Data also gives them the ability to see the hidden discount in managed care, i.e., denials and short pays. Getting electronic right means knowing what the bills, payments, and correspondence look like. It enables decision support or analytics or even AI or automation.

The next level is taking data and automating processes instead of sending them back to a work queue, and that's where you would use your banking partners. We'll get there eventually, and that's the dream.

Rodgers: I also recommend identifying the different technologies that will fit their specific workflows. Sometimes there's a fear that paperless solutions won't meet workflow needs so identifying technologies that will increase productivity and efficiencies and being able to successfully measure and benchmark the success is important.

We always talk about people, process, and technology. Providers have to focus on the people aspect and identify a plan to shift the culture away from paper based processing so that everyone is moving forward together and in the same direction.

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The Bank of New York Mellon Corporation published this content on 11 October 2018 and is solely responsible for the information contained herein. Distributed by Public, unedited and unaltered, on 11 October 2018 17:07:01 UTC