Banks & Healthcare Payment Automation
Today’s Healthcare Bank Lockbox Climate
A Brief History
Most banks now recognize that their lockbox revenues related to healthcare are at risk with the advent of ERA and EFT. In an industry that processes more than $1.5 trillion dollars a year - and is as complex as any industry out there - the choices of how a bank participates in this space must be carefully weighed.
More intriguing to banks, the volume of transactions and funds will only increase the stakes as time passes. The annual U.S. healthcare expenditure is estimated by USA Today to reach $4 trillion, or $12,320 per person annually, by 2018.
Healthcare is a business where payers are not likely to pay what a provider bills. The provider needs to follow-up on as much as 30-50% of the insurance payments it receives, depending on specialty of the operation. Remittance is based on a very detailed contract between the payer and the provider. The struggle to determine where an adjustment should be made, whether it should be on the billing side vs. the remittance side, is a result of the often relatively simple provider billing software contrasted with the complexities of the payer claim processing system.