A Love Letter to Insurance Companies
Dear Insurance Companies,
Please seek direct feedback about your website portals from revenue cycle companies, who are the daily users of your sites. I would love to tell you all the ways your site compares to other companies, its functionality (or lack thereof). I could share the frustrations I have that led me to continuously contact your call center, begging for some sort of direction or assistance to resolve my issues.
I think about the resources you waste having consulting firms come in and tell you why the site, the process, or the technology are not optimized. I would love to tell you all this out of the goodness of my heart (and maybe some selfish need in hope some of these fixes or improvements will occur and make my life a little easier).
I would like to say the updates you have made over the years have made my world easier...they have not. I now long for you to call me, for us to have a open discussion about our relationship, and if it will always be such a struggle for us to communicate. Together we can make waves of change to this jumbled healthcare industry.
Waiting for your call, Lydia
Payor linking for healthcare billing has been the bane of my existence for over five consecutive years. Maybe I have become biased because of very few good experiences, but somehow I do not think that is the case. Let's talk payor websites.
Did you know, in my past five years of working directly on the payor website, and payor administrator portals, I have only ever had one of them contact me directly for feedback? And this only happened last week...
I know there has to be some sort of template out there; New location/group/provider, TIN linking, bank linking, administrative access, user access, EFT/ERA management, profile management. Pretty much any site you visit has some sort of this framework. However, the variations are drastic. I am the administrator, the business office for these provider groups, and yet many of these payor sites are asking for the leader/owner of the business to call in and log in and make changes to the site. Not everyone is an outpatient or PCP-type business where the owner can be called to the phone to approve the site or administrative access my team needs to manage their business. That's why my revenue cycle roles exist, right? So the provider can focus on patient quality and care and not if Suzie has access for payment posting?
Let us not forget those sites where, to even start the access process, I submit a lengthy set of information on my business letterhead, with my information linked. Yet, they have me verify these 10-20 fields of information, that I personally gave them. I understand checks and balances and verification of people to make changes on an entity's behalf, but this is getting out of hand.
If all else fails, call the provider services, or provider demographic help lines, right? Well, for normal business needs maybe they work. But if my question or request does not fit the specific script the representatives have been given, they are completely lost. Instead we get passed around for more than an hour, to different departments, waiting on hold each time. by the end, we are frustrated, and our issue has not been resolved, yet even understood. We are not trying to be difficult. I would be absolutely thrilled if my team could self-service via the website, if we had a instructions that seamlessly got the results of linking and optimization.
Here's the deal, if you contact me, I will give you feedback for free, and I will answer any questions you have about development/changes you want to implement. I will help you troubleshoot and create meaningful user guides/instructions. I will describe variations of facility, PCP, OP, IP, and management structures that you may not have considered for each proposal. I will let you know what other payor websites are doing that makes these processes efficient. Let's tear down these walls of healthcare, starting here. Starting today.
Here is a growing list of the various payor website my team and my RC vendors interact with daily.
BCBS of [State]
Change Healthcare - ProviderNet
Change Healthcare - Change National Payment Connector
Change Healthcare - Claims & Denials
Echo Provider Payments
Global Excel Management
PNC (via Jopari)
VENTANEX Provider Pay
Point Comfort Underwriters
ProCare Advantage EZ-NET Provider Portal
Tricare East (via Humana)
Tricare West (via hnfs)
Tricare4U/Tricare for Life WPS