goes beyond the basics
Health care insurance plans in which consumers bear a portion of
costs – consumer-directed health care (CDH) – are increasingly
prevalent in the US, a development that leaves existing payment
solutions falling short of requirements, believes banking and
payments technology developer Metavante. However, with its new
internet-based Metavante Healthcare Gateway (MHG) product,
Metavante claims to have a solution that solves many challenges
facing CDH plan providers.
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Two major challenges are coping with member eligibility
verification and claim status inquiries from health service
providers faced with increased payment collection
responsibilities.
According to Metavante, 60 percent of calls received by its CDH
plan clients from service providers relate to eligibility
information and verification, while 25 percent relate to claim
status inquiries. To address these issues, MHG enables service
providers to use an online interface with plan providers to get
eligibility, claims and payment tracking information.
Other key features of the MHG offering include electronic claim
submission to health plans, automated clearinghouse payments
processing, electronic remittance advice and explanation of
benefits distribution. Health care providers can also access MHG
via a card reader. This enables providers to initiate eligibility,
claims and payment activities using a magnetic stripe-equipped
eligibility card or a combination eligibility and payment
card.
“Healthcare Gateway fulfils the financial cycle for a provider,
from the time a patient walks in the door until the provider has
been paid and the payment has been posted,” said Metavante’s
Healthcare Payment Solutions’ president, John Reynolds.
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By GlobalData“Health care electronic data and payment interchange adoption can
only increase across the industry when eligibility, claims, payment
activities and related tools are all available as a suite. Tools
that work together, like those coming together to create Healthcare
Gateway, can finally entice providers and payers to move beyond
paper-based legacy systems.”
