Electronic Payment Key to Streamlining Healthcare Claims Management

The complexity around healthcare claims management is a major pain point for provider organizations, big and small. The increasing cost of claims coupled with a complex system of many payers, each with their own rules and requirements, creates administrative burdens and obstacles for providers. Ultimately, this complex system impacts the patient experience, as patients must wait on payers and providers to process claims to send them a bill.

Payers and providers alike have turned to digitization to streamline the healthcare claims management process. Electronic adoption of claim submission, attachments, coordination of benefits, and other parts of the claim process has increased significantly over the last couple of years, and to great benefit to providers.

But more efficiencies and savings can be realized. CAQH estimates that payers and providers could collectively save another $16.3 billion by fully automating nine common transactions, including claims payment and remittance advice.