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By Benny Tate, ibml

Healthcare reform may no longer be front page news, but it's impact on healthcare payment processing will be significant. This article explores options for healthcare payment automation that can streamline your claims processes in the reform era.

Recent events may have pushed health reform from the front page of the newspaper, but that won't last for long. The healthcare industry continues to face a tense political climate, skyrocketing costs for care and administration, increasing competition among providers and payers, more stringent government regulations and compliance guidelines, and high rates of underpayment and bad debt.

Against this backdrop, the healthcare industry remains the fastest-growing segment of the U.S. economy -- accounting for an eye-popping 14 percent of the country's gross domestic product (GDP).

Payments processing represents a significant chunk of the healthcare industry's costs. And it's for good reason: the healthcare industry generates more than 15 billion claims, electronic remittance advices (ERAs) and explanation of benefits (EOB) documents each year, on top of 3.4 billion claims and 1.1 billion payments. With a single EOB costing an average of $3 to $9 to process -- thanks in large part to the fact that only 60 percent of providers can even receive electronic remittances -- it is easy to see how the expenses mount. What's more, over 800,000 healthcare claims go unpaid every year, and the amount of bad debt incurred by providers would make a congressman blush.

How did the healthcare payments landscape become so costly?

It starts with the fact that there are more than 1 million healthcare providers in the U.S., including:

• 1 million physicians/practices
• More than 125,000 dentists
• More than 45,000 chiropractors
• More than 53,000 pharmacies/drug stores
• More than 19,000 nursing homes
• More than 13,000 podiatrists
• More than 13,000 vision outlets
• More than 10,000 osteopaths
• More than 6,500 hospitals

Historically, this large and diverse group of providers has made it difficult for the healthcare industry to standardize its payments processes. The problem became even more pronounced with mandates such as ICD-10, which divert limited IT funds and internal resources from payments automation. Access This Content To Read This Article In Its Entirety.