Health & Financial Network Solutions

The healthcare industry is in the midst of major transformation.

The emergence of Consumer Driven Healthcare (and the resultant shift of healthcare costs to consumers) has brought renewed focus and energy toward addressing the high cost and inefficiency of current healthcare eligibility, claims, and payment processing. This process has been problematic for a long time, but the continuing rising of healthcare costs and recent technology advancements are forcing this issue to the forefront.

Disparate systems and a lack of standards in general are limiting the progress towards “electronification” of claims and payment processes. This means more human intervention is required to conduct routine inquiries such as eligibility verification and claim status checks. Manual processes are driving up operational costs and administrative time for both payers and providers – and slowing the revenue cycle overall. With CDH likely to drive up the volume of consumer payments, this poses significant risk to providers – who must now place unprecedented focus on revenue cycle management.

Metavante can help.

Metavante helps accelerate the revenue cycle for healthcare providers with a suite of Health and Financial Network solutions that encompass all claims and payment activity. Through one complete provider dashboard, providers can perform realtime eligibility verification, submit claims, check claim status, receive claim adjudication, view payments, electronic remittance advice and Explanation of Benefits (EOB) documents, and re-associate claims and payments. Integrated payer payments and remittance advice distribution and provider lockbox/receivables management solutions ensure the complete claim-to-cash process is covered.

With improved tools for both payers and providers, Metavante helps eliminate manual processes and disconnected systems/workflows. Through the Health & Financial Network, providers can receive information from any payer – meaning that they no longer have to follow different processes and use different technology to interact with individual payers. More claims can be submitted electronically to payers, and more payments can be received electronically from payers. For providers, this means better control over their revenue cycle – fewer unpaid claims, easier tracking and reconciliation of payments, improved operational efficiency, and lower costs.