The healthcare sector offers numerous opportunities for breakthrough change, often hidden behind deep-rooted fragmentation and inefficiency.
And at the heart of this Ecosystem, caught between traditional processes and the promise of technology-driven transformations, offers better healthcare services.
To understand how the evolution of healthcare billing and payment can reduce the complexities faced by consumers and providers and streamline healthcare delivery, PYMNTS CEO Karen Webster sat down with Tom FurrCEO of PatientPayAnd Ryan ZemminCEO of ClearGageto discuss not only Tuesday (27 August) fusion from of their two companies, but also how digital innovations are improving the patient experience in healthcare billing and payment.
“We’re trying to digitize a largely paper-based system through which most healthcare bills are sent,” Furr said. “Forty-five percent of healthcare bills are sent in paper, and outside of healthcare, that’s not the norm.”
He attributed the persistence of paper billing to the inherent complexity of healthcare payments and the challenge of changing long-established practices. And while the pandemic accelerated the transition to digital solutions as healthcare providers were under pressure to maintain efficiency, the macroeconomic environment has left healthcare systems struggling in the face of rising costs and reduced government support.
Read more: PatientPay and Higher Standards collaborate on a payment acceptance solution in healthcare
Transparency and consistency
In healthcare, revenue cycle management is a critical aspect, with collection rates playing a major role in maintaining financial stability. Traditionally, paper statements have been the primary method of billing patients, but this approach is considered outdated and inefficient. As healthcare companies strive to streamline their collection processes, many are turning to digital payment solutions to improve both the speed and success of patient payments.
The recent merger between PatientPay and ClearGage, said the two executives, represents a strategic alignment aimed at the evolving needs of the healthcare payment landscape. The merger was initiated after both companies recognized their complementary strengths and the potential for greater impact by working together.
“We were looking for a PayFac (payment facilitator) solution and ClearGage had a registered PayFac,” Furr said. “They also had a solid eligibility and estimating solution that perfectly complemented our back-end billing and payment capabilities.”
By combining their resources, the two companies aim to create a unified platform that improves the patient experience while giving healthcare providers the tools they need to increase efficiency and reduce costs. The merger is expected to bring a wide range of capabilities, including treatment estimates, eligibility assessments and streamlined billing processes, under one roof.
Finally, the complexity of the billing process is one of the biggest obstacles to timely payments in healthcare. Patients often have difficulty understanding their bills, especially when there are multiple charges from different providers. Even those who are well versed in the industry can find healthcare bills confusing.
“If you can give someone an insight into the cost of a procedure up front and then offer them a range of payment options for that service, it gives them much more confidence in their ability to not only Service, but to be able to afford it,” said Zemmin.
As healthcare payments continue to evolve, both Zemmin and Furr emphasized the importance of transparency and consistency in the patient experiencean approach that not only benefits patients, but also helps healthcare providers improve appointment adherence and reduce the administrative burden associated with payment tracking.
The way forward
Despite advances in healthcare billing and payment, inconsistencies among healthcare providers remain a challenge.
Furr highlighted the siloed nature of healthcare, where patients often encounter different payment systems and experiences with each provider they visit. To address this problem, PatientPay has developed a patient-centric approach similar to PayPal that allows patients to manage all of their healthcare payments in one place, regardless of provider.
“Healthcare has traditionally been focused on medical groups and has paid little attention to the patient experience,” Furr explained. “We have taken a different approach and focused on the patient as the center of the healthcare payment ecosystem.”
Tactics like integrating Explanation of Benefit (EOB) data into billing information can make it easier for patients to see exactly what they owe and why. This transparency, combined with the convenience of digital payment options, has resulted in a 44% payment rate among users who log into the PatientPay platform, according to Furr, with 70% of those payments made via mobile devices.
Ultimately, reducing paper bills and offering digital payment options not only streamlines the billing process but can also improve cash flow for healthcare providers.
And the future of healthcare payments lies in further simplifying and standardizing the billing process between providers. Zemmin and Furr both envision a system where patients receive clear, upfront estimates and the billing process is seamless and consistent across all healthcare interactions. They believe the industry can advance by leveraging technology and focusing on the patient experience away from the traditional, fragmented approach to a more unified and efficient system.
“The key is to reduce the complexity of medical billing and simplify it so that patients understand it and then give them the ability to pay easily,” Furr said.
