Healthcare Providers Embrace Digital Payments to Simplify Billing

The healthcare industry is tackling long-standing challenges in payment processing, reconciliation, and revenue cycle management by turning to digital solutions, according to PYMNTS. Billing complexities arise due to varying rules between insurance payers like Medicare and Medicaid, creating administrative hurdles that impact cash flow and divert resources from patient care.

«Automation can significantly transform the payment reconciliation process in healthcare,» said Dean Puzon, President and co-founder of Big Data Healthcare (BDHC), a subsidiary of Fifth Third Bank, in an interview with PYMNTS. By adopting automation, machine learning, and emerging technologies, providers aim to streamline payment processes, reduce errors, and enhance financial management.

Automated systems developed by BDHC can match payments to billed amounts in real time by cross-referencing data from electronic claims and remittance files. Integrating electronic health records (EHRs) and electronic medical records (EMRs) with billing systems facilitates seamless data flow and minimizes the need for manual intervention.

Puzon emphasized the importance of distinguishing between automation, machine learning, and artificial intelligence (AI). «Automation refers to the use of technology to perform tasks with minimal human intervention,» he explained. Machine learning is suited for predictive analytics like forecasting claim denials, while AI can analyze patterns in claims data to improve decision-making and optimize revenue strategies.

Looking ahead, emerging trends such as the shift from fee-for-service to value-based care will require new payment models focused on quality metrics and outcomes. The increasing adoption of digital payments, including mobile wallets and contactless options, is also making healthcare transactions more convenient for patients.

Banks play a crucial role in supporting these advancements. Through partnerships with fintech companies like BDHC, they can offer innovative payment solutions tailored to healthcare providers’ and patients’ needs. Financial institutions can also assist with risk management and promote health savings accounts (HSAs) to give patients more options for saving on healthcare expenses.

«The future of healthcare payments will be dynamic,» Puzon concluded. «Institutions that embrace technology-driven solutions will emerge as key players in the evolving healthcare ecosystem.»

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