How Payers Can Drive Provider Engagement: 3 Strategies

How Payers Can Drive Provider Engagement: 3 Strategies

Manual processes for medical and dental providers are expensive and time-consuming. In 2021 $42 billion was spent on administrative transactions.¹ It's estimated that $20 billion can be saved annually by transitioning to fully electronic transactions. While there has been an increase in adoption from 2018, providers are still processing more than 50% of their payments manually. The trepidation to fully adopt electronic transactions that would enhance provider engagement is a significant hurdle. Let's look at how the landscape has changed recently and discuss three strategies payers can implement to increase provider engagement.

Quick Links

How COVID-19 Impacted Administrative Functions of the Healthcare Industry

Why Increasing Provider Engagement is Important

The Financial Impact of Manually Processing Payments

Adoption of Digital Transactions Remains Low

3 Strategies to Increase Provider Engagement

A Comprehensive Approach to Electronic Adoption Increases Provider Engagement

How COVID-19 Impacted Administrative Functions of the Healthcare Industry

COVID-19 played a part in the increase in electronic payment processing adoption simply because there was no other option. The world had gone on lockdown to prevent the spread as health care providers became inundated with an increase in medical claims from patients infected with the disease. Telemedicine services became commonplace for those with non-life-threatening health issues. The use of technology and automated transactions increased as health plan, and provider administrative staff began working from home and didn't have access to office faxes, call centers, and mail facilities.

COVID-19 also increased the use of contactless payment methods in the healthcare industry. What this did was decrease foot traffic to medical offices, the residual cost of processing, and the likelihood of late payments due to the ability of electronic transactions and automated email reminders. From a consumer perspective, it increased our dependence on all things digital. So while COVID helped accelerate the adoption of electronic transactions, there is still a long way to go.

Why Increasing Provider Engagement is Important

Improving provider engagement can directly impact health plan performance through improved clinical outcomes and quality ratings, member retention, and overall efficiency. Increased provider engagement helps improve administrative efficiency, meet regulatory requirements, and enables payers and providers to manage new reimbursement strategies.

The Financial Impact of Manually Processing Payments

According to a 2021 study done by CAQH® that measures national progress in reducing the costs associated with conducting administrative transactions in the health care industry for medical and dental plans and providers, the potential annual savings in money and time per transaction are significant:

Prior Authorization: $437 million | 16 minutes

Claim Submission: $1.7 billion | 6 minutes

Electronic Attachments: $286 million | 6 minutes

Claim Status Inquiry: 3.1 billion | 22 minutes

Claim Payment Savings: $577 million | 4 minutes

Remittance Advice: $1.8 billion | 7 minutes

Adoption of Digital Transactions Remains Low

Providers have been slow to adopt fully electronic transactions. It's understandable. It's unfamiliar, and the process of digitizing can seem overwhelming.

Health plans have indicated that if they could provide the following strategies to providers, it would enable them to be more receptive to going paperless and, in return, increase engagement.

  • Education for providers about how the process works
  • A plan for transitioning their providers to paperless payments
  • Ongoing support to overcome provider challenges

To help increase adoption and increase provider engagement, health plans should implement these three strategies.

3 Strategies to Increase Provider Engagement

1. Educate Providers About How the Process Works

One of the obstacles payers face is the skepticism from providers about having third-party vendors manage payments. The common misunderstandings typically include:

  • A lack of understanding of the true benefits of electronic payments 
  • Reluctance to share banking information with health plans
  • Unfounded fear that health plans can withdraw funds from provider bank accounts
  • A misconception that they cannot manage the process 
  • ePayment security concerns

Providing education for providers will clear up these misconceptions about using a third-party vendor and help get more on board.

2. Provide a Transition Plan

A strategically designed provider outreach program with a plan that combines automated email, phone, and print can make it easy for providers to participate. An individualized plan based on the needs and capabilities of the provider makes the transition smoother and provides the opportunity for higher enrollment from providers. Transition plans are more impactful when conducted in phases that include progressive calls to action reminding providers to register for electronic payments by a certain date. Here are a few items to consider for your provider transition plan:

  • Launch a three-step email campaign to providers offering a simple and easy registration
  • Implement ongoing EFT enrollment emails promoting the benefits of being paid via EFT/ERA and virtual cards
  • Execute outbound calling campaigns for the highest volume providers
  • Provide Go Green incentives for providers
  • Enable automatic enrollment in the EFT/ERA/virtual card system at the conclusion of campaigns

3. Offer Ongoing Services to Augment the Transition

Provider engagement involves more than just enrollment. Support throughout the process helps to ensure them that the process is going smoothly and they have the assistance they need if they have questions. It's also important that providers are able to take an active part and monitor the progress of the transition.  

  • Intensive, ongoing EFT enrollment emails offer a simple and easy registration process. 
  • Webinars for providers and their staff to provide training and education on enrollment-related topics.
  • Daily access to services specialists to assist providers with questions and requests for information.
  • Ensure health plans have the ability to track and monitor the progress of email campaigns and provider enrollments.
  • A dedicated portal where providers can access messages from health plans.

A Comprehensive Approach to Electronic Adoption Increases Provider Engagement

At Payspan our goal is to enable strong partnerships and positive relationships between payers and providers that result in enhancing their relationship. Transitioning providers to digital transactions with strategic provider enrollment campaigns are the first step. We would love to talk about our role in eliminating the essential problem driving lack of provider engagement – manual, inconsistent and complex communications that are costly and labor-intensive to the provider and fail to demonstrate value to the provider’s bottom line. PaySpan’s Core Payment Network is a technology platform that enables the secure processing of electronic payments (EFT/ACH) and remittance information (ERA) for medical health plans and providers, as well as dental insurers. Download our eBook How to Drive Provider Adoption of Electronic Payments and Reimbursements for more information.

Download the eBook