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The financial health of provider organizations depends on collecting every dollar due. Efficient processes and automated workflow to assure accurate and timely payment for healthcare services is vital to the ability of hospitals, health systems and physician practices to provide high levels of care, and successfully compete in today’s market.
While optimizing payer payments has always been a priority, more recently, as the patient’s share of cost-of-care has increased to as much as 40%¹, the importance of facilitating patient payments has increased as well. Today’s uncertain payment environment is fraught with confusion and frustration on the part of patients dealing with higher premiums, increasing deductibles and the need to shop for healthcare based not just on quality, but also price.
The complexity of health plan contracts adds to the uncertainty: National payers make approximately 13,000 payer policy changes a year each, making it more difficult than ever for providers to achieve payment certainty in the payer arena as risk escalates.
Boosting financial performance depends on providers helping patients navigate healthcare as consumers, with the need to understand the costs and expectations newly placed upon them. Providers must also work closely with insurers to assure their ability to stay true to their mission and values.