Efficient Claims Processing for Multi State Healthcare Network
Client: Large multi state healthcare provider network with over 200 affiliate physicians and hospitals.
Challenge:
- The provider network face delays in claims processing and results in late reimbursements. It increase administrative costs and difficulties in managing claim statuses. Manual claim tracking was prone to errors, leading to further delays.
Solution:
- The healthcare provider implemented Zelis Payments to streamline its claims submission process. By utilizing electronic claims submissions, real time claim tracking and automated notifications, Zelis enabled the network to reduce manual claim handling.
Results:
- Faster Reimbursements: Claim processing time is reduce by 30% and resulting in faster reimbursements.
- Fewer Denials: The automate tracking system identifies claims in need of correction early reducing claim denials by 25%.
- Improved Cash Flow: With quicker payments and fewer administrative issues the provider network experienced 15% improvement in cash flow.
Key Takeaway:
- The use of Zelis Payments automate features significantly enhanced the claims process, reduce operational costs and improved financial stability for the healthcare network.
Patient Payment Transparency and Reduce Late Payments
Client: Regional hospital system with over 50,000 annual patient visits.
Challenge:
- The hospital system faced challenges with late payments from patients. Multiple patients are unaware of their financial responsibilities til their visit, leading to late payments, missed appointments and increase administrative costs to follow up.
Solution:
- By integrating Zelis Payments the hospital set up automate payment notifications and remind patients of their upcoming payments and balances due. They offer multiple payment options. It including credit card payments and payment plans via Zelis platform.
Results:
- Reduce Late Payments: Payment reminders reduce late payments by 40%.
- Improve Patient Experience: Patients report more transparent billing experience. It leads to increase satisfaction and fewer billing related complaints.
- Streamlined Collections: The hospital’s collections process became more efficient, as patients easily pay via the platform or opt for manageable payment plans.
Key Takeaway:
- Zelis Payments multi channel notifications and flexible payment options enable the hospital to reduce late payments and improve patient engagement, contributing to better financial health.
Streamlining Payment Processing for National Payer
Client: National health insurance payer with millions of members across the U.S.
Challenge:
- The payer struggles with inefficiencies in payment processing. The complexity of managing multiple payment methods and scure timely payments to providers. The existing system is cumbersome and lacks integration with the payer’s backend systems, leading to delay claims and payment errors.
Solution:
- Zelis Payments implement to centralize and automate payment processing. The payer transition to electronic funds transfer and direct deposit for healthcare providers. Zelis integrates seamlessly with the payer’s existing infrastructure, providing secure, real time payment tracking and notifications.
Results:
- Faster Payments: The transition to EFT and direct deposit sped up payment processing reducing payment time by 50%.
- Increased Provider Satisfaction: Providers report improve satisfaction with faster, more accurate payments.
- Reduced Administrative Costs: By automating payment reconciliation and reducing paper checks administrative costs decreased by 20%.
Key Takeaway:
- Zelis Payments help the payer optimize their payment processes, improving both the speed of transactions and provider satisfaction while reducing operational costs.
Improve Financial Management for Multi Provider Group
Client: Group of independent healthcare providers. It includes general practitioners, specialists, and outpatient clinics by 100+ locations.
Challenge:
- The group faced difficulties in managing payments and claims across multiple locations. Payments were delay, and tracking the status of claims is challenging due to the manual nature of the process.
Solution:
- The group adopted Zelis Payments to centralize its payment and claims management. The solution includ automated payment notifications to ensure the providers receive immediate alerts when payments were made or if claims are deney.
Results:
- Better Cash Flow Management: Automated notifications help providers quickly address denied claims, improving cash flow by 35%.
- Simplified Payment Tracking: The centralized payment system provided real time tracking of payments, remarkably reducing administrative time spent on inquiries.
- Operational Efficiency: The group reduced the need for dedicated administrative staff to handle payment inquiries, cutting costs by 15%.
Key Takeaway:
- Zelis Payments is centralize solution and provides the provider group with better visibility into payment and claims statuses. It enables quicker response times and improves overall financial management.
Reducing Denied Claims for a Large Medical Group
Client: A large medical group with several specialized departments, handling thousands of claims each month.
Challenge:
- The medical group experience high rate of denied claims, It cause significant delays in payments and adds to the administrative burden of addressing and resubmitting claims.
Solution:
- The medical group adopted Zelis Payments to integrate automated claim tracking and notifications for pending, approve or deniey claims. By using the system’s automates alerts, the group could quickly address errors and resubmit claims with accurate data.
Results:
- Dramatic Reduction in Denials: The rate of denied claims decrease by 40% due to faster identification of issues.
- Faster Claims Processing: Claims previously took weeks to process were now handle in days.
- Improved Provider Revenue: With fewer denials and quicker reimbursements, the medical group saw a 25% increase in revenue.
Key Takeaway:
- Zelis Payments automates claim status notifications enabling the medical group to address issues quickly, reduce claim denials and improve their revenue cycle efficiency.
Read Also: Testimonial: Efficient Claims Processing
Conclusion
These case studies demonstrate how Zelis Payments has successfully help various healthcare organizations streamline their payment and claims processes, improve cash flow and enhance provider and patient satisfaction. By automating key processes, offering flexible payment options and providing real time payment tracking and notifications, Zelis enables healthcare providers and payers to operate more efficiently and deliver better financial outcomes.