Claim Payments: Your Optimization Blueprint

A guide to solving your biggest reimbursement pain points.


While last year had many challenges, it also catapulted the evolution of healthcare payments. From dramatic reduction in revenue to risks associated with COVID-19, the industry dealt with unprecedented obstacles that forced it to adapt.

With non-emergent patient visits virtually eliminated or downgraded to virtual reimbursement rates, healthcare providers need to find a more seamless way to get paid. That’s why we created our free eBook: “Claim Payments: Your Optimization Blueprint.” Discover the insights to optimize your payments and solve your biggest reimbursement pain points.

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Here’s what you’ll learn:

Driving Savings and Simplicity

The pandemic has fundamentally changed how providers think when it comes to getting paid. Keeping safe from COVID-19 has taken precedence over everything else. People are taking much more precaution when going about their daily activities.

Staff aren’t too keen on getting checks delivered in the mail or taking them to the bank for processing anymore. There’s simply too much unnecessary risk of exposure.

Also, the average cost of processing a paper check is approximately $6. When you think of how many checks you’ve been processing annually, the cost really adds up.

By switching to electronic payments, the medical and dental industries could save a combined $898M annually.

Ditching checks reduces cost, helps protect staff and also has less negative environmental impact. For all these reasons, the medical industry has experienced a steady rise in adoption. This past year has made it clear that providers need a different solution to help them adapt to the impacts they’re facing today.

How to Optimize Your Payments

In today’s complex healthcare payments landscape, there are multiple factors putting stress on your bottom line. From increased regulation to shifting patient financial responsibilities, providers are facing an uphill battle in trying to generate revenue.

By converting to direct deposit you eliminate manual processes and workarounds. Forget about coming into the office or going to the bank just to get paid. Keep your income flowing into your account with electronic payments. And it’s completely contactless. No touch – no problem.

How to Solve the Long Tail Payer Problem

Long tail payers have always been a problem for providers. They’re mostly out of network and use paper checks to deliver payments to providers.

Investments in EHRs and practice management systems have created opportunities to drive efficiencies for providers with Medicare and Medicaid and large commercial insurers as well as with bundled clearinghouse enrollments. However, the pandemic has put a high-powered spotlight on the next wave of opportunities.

Providers need to take a magnifying glass to the long tail left in the revenue cycle and seek solutions across a large pool of your long tail payers including medical, dental and workers’ compensation plans.

How to Close the Gaps in Electronic Payments

With such complexity still existing in healthcare payments, how can I get paid better? We’re sure this question has been on your mind. By using this step-by-step guide, you’ll have all the answers you’ve been searching for.

Whether you’re a small private practice provider or a large health system, everyone needs to find the solution that works best for their specific needs. Having several options for getting paid makes thing easier all around.

By implementing Zelis ACH, you can realize huge gains in efficiency and savings. Stop waiting around to receive your money and optimize payments with electronic payments. Get your funds delivered weeks faster than mailed checks. Not only does it save time, but also improves efficiency and drive savings. Reconciling claim payments is no easy task, especially on a large scale.

With auto-reconciliation, we make it easier for you to get paid. Zelis allows for a simplified reconciliation process by delivering up-to-date payment information to your core system, which enables in-system balancing.

Receive payments within three days with virtual cards by simply entering the virtual card number into your card terminal. It’s that easy. Forget about individually inputting payments. You can consolidate payments from multiple payers into one transaction.

With both ACH and virtual cards, providers get contactless data with a provider portal. The Zelis Provider Portal allows you to remotely access and download payments history by claim or patient up to 10 years. With our 835 data delivery feature, you receive error-free and detailed electronic remittances in real-time to 60+ clearinghouses. Zelis ACH automatically settles 835s and payments directly into your bank account. Data can be delivered in several formats including 835, PDF, Excel (CSV), etc.

While there’s no way to know what may come, this blueprint will help serve as a roadmap to success. The challenges you’re facing are complex require customized solutions to help you overcome them.
Forget about the roadblocks of the past. With this eBook, you have the tools and expertise to forge ahead. Zelis Payments can help you every step of the way.

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