Interoperability value for health plans and payers
May 9, 2021
Cut the Costs of Claims-Related Transactions
Processing claims-related transactions through a data clearinghouse comes at a high administrative cost. In fact, healthcare organizations spent about $40 billion in 2019 in administrative transactions, according to CAQH, a non-profit alliance of health plans and related associations. This includes transactions such as:
– Eligibility and Benefit Verification
– Prior Authorization
– Claims Submission
– Coordination of Benefits
– Claim Status Inquiry
– Claim Payment
– Remittance Advice
Many health plans use data clearinghouses for these transactions. Whether the clearinghouse charges a flat rate or per-transaction, the costs add up. Cutting the middleman for just one of these categories can save payers and health plans considerable costs.
In the infographic Cut the Costs of Claims-Related Transactions, we illustrate how an integration engine can bypass the clearinghouse for Eligibility and Benefits Verifications.
Why Eligibility and Benefit Verifications? Because health plans make approximately 30 of these transactions per member per year according to the 2019 CAQH Index.
Lyniate’s interoperability solutions – Corepoint and Rhapsody – can be configured to route transactions and facilitate the process of verification, thus eliminating the need for a clearinghouse and providing significant cost savings.
Lyniate partners with healthcare organizations around the globe delivering cutting-edge solutions to address interoperability challenges. Our industry-leading products, Corepoint and Rhapsody, are used by thousands of customers to send hundreds of millions of messages every day. Lyniate is committed to delivering the best interoperability solutions for healthcare organizations, from specialty clinics to large networks, from payers to vendors, and everything in between. We’re building the future of interoperability.
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