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The Health Care Industry is Drowning in Paper!

Health care is a $2 trillion industry that is expected to grow to close to $4 trillion by 2014.  Of this amount, around $400 billion is spent on non-value adding paperwork and administrative costs.  While overall expenditures are expected to increase 7% per year through 2014, both payers and providers face increasing pressure to slash the $400 billion of non-value adding costs.  One step toward that goal is to get rid of all the paper!

For payers, paper checks and remittance advices come with bank fees, increased losses due to check fraud, postage, paper and printing expenses.

For providers, paper checks and remittance advices result in manual keying, reduced cash flows and higher staffing expenses.

The Solution is Going Electronic
As of today, 95% of claims are settled with paper checks and paper remittance advices.  OptumHealth Financial Services' Electronic Payments & Statements product can simplify the entire process, increase your operational efficiencies, reduce operating costs and do it all in a highly controlled and secured environment.

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Why Choose OptumHealth Financial Services?
Electronic Payments & Statements (EPS) product is a fully integrated Electronic Remittance Advice (ERA) and Electronic Fund Transfer (EFT) solution. The EPS network is the largest provider network in the industry, with more than 50,000 TINs. OptumHealth Financial Services also leads the industry by processing more than $1 billion in EFTs and 8-10 million ERAs per month.
 
For payers, migrating providers to Electronic Payments & Statements saves 20-50% in administrative expenses over paper-based transactions. EPS eliminates costly manual and paper-based processes that create needless administrative expense for payers. In addition EPS does away with unnecessary expenses such as banking fees, postage, printing, manual labor processes, raw material holding cost, calls related to check status, and voided/returned checks.

For providers, adopting Electronic Payments & Statements saves money, time and improves overall efficiency.  In addition, this is a free service that requires no expensive hardware, software or license investments.  Once a provider has completed the online enrollment process, they can easily download and view Electronic Remittance Advices (ERA).  This ability will eliminate the need to re key information into the Practice Management or Patient Accounting System.  Electronic Funds Transfer (EFT) payments go directly into your bank account, improving cash flows, reducing claims outstanding and eliminating the need to handle and deposit checks. 

Features & Benefits

• Product first released in 2003
• Largest provider network (50,000 TINs), with presence in all 50 states
• Day one provider adoption will range between 30-40%, based on our current provider network
• Largest volume of ERAs and EFTs
• Claim splitting – will support dual electronic (EFT) and paper settlement
• Consolidation engine which performs HIPAA validation
• Downloadable HIPAA 835 data from portal or view ERA in a PDF format
• Dedicated primary and escalation call center support
• Lead non-face to face provider adoption
• White label product capabilities
• Implementation and training support services
• On-line reporting and query tools
• Maintain existing financial institution relationships
• Print facility processes more than 1.2 billion images and mails 250 million envelopes annually

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How does Electronic Payments & Statements work?

Payers send unconsolidated 835 payment files to OptumHealth Financial Services:

• OptumHealth Financial Services creates a NACHA-compliant file at the provider level and distributes ACH payments.
• EPS runs the payer file through a consolidation engine to reduce transactions by combining multiple payments to the same provider into 1 payment.
• ERAs are delivered to the provider through a clearinghouse or payer. Paper remittances are processed and mailed to the provider through OptumHealth Financial Services’s print facility.

• OptumHealth Financial Services creates a NACHA-compliant file at the provider level and distributes ACH payments.
• Payment and remittance advice information is posted online for easy payer and provider access (paper and electronic).
• OptumHealth Financial Services’ print facility processes and mails all paper payments.

By utilizing OptumHealth Financial Services' extensive provider network, payers can quickly activate many of their high-volume claims providers and achieve meaningful cost savings from day one. To help during your transition, OptumHealth Financial Services’ high volume print facility can efficiently manage your paper based transactions while we work with you to migrate to paper-free electronic processing. 

To learn more about how an OptumHealth Financial Services’ Electronic Payments & Statements product can benefit your organization, please email us at eps@optumhealthfinancial.com.