“The Missing Link in Provider Payments,” a new DataPath white paper, reveals how increases in medical costs and the number of providers for each claim are driving a need to modernize the workers’ compensation revenue cycle. DataPath, an Arkansas-based workers’ compensation payments solution provider, also highlights the benefits of a potential alternative—virtual payments.
Traditionally, providers have been reimbursed for claims via electronic funds transfer (EFT) or check. However, the white paper discusses how these traditional payment methods can lead to errors, duplication of payment and even fraud. In fact, according to the 2015 AFP Payment Fraud Survey, “checks remain the most-often targeted payment method by those committing fraud attacks.” Examples of associated risks are included in the chart below.
|Postage & printing fees||X|
|Higher propensity for fraud||X||X|
|Inquiry calls to adjusters||X||X|
|Higher administrative costs||X||X|
|Duplication of payments||X||X|
|Inability to tie EDI directly to claim system||X||X|
|No 24×7 support||X||X|
|Hidden service fees||X|
|Inability to attach EOB||X|
In addition, check writing is expensive – processing and postage fees not to mention costs associated with lost or late checks add to claims costs, the paper’s author writes.
The white paper suggests virtual payments as an alternative reimbursement method that streamlines the workers’ compensation revenue cycle for both payers and providers.
“A key challenge for workers’ compensation payers is the ability to process payments cost-effectively and efficiently, while attaching an explanation of benefits so that the provider can easily adjudicate the payment,” said Dave Stair, director of insurance payment solutions for DataPath. “Many payers are pushing multiple payments to a single provider each week, adding unnecessary administrative pain points. Virtual payments give them a new alternative.”
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