Payment system helps practices cut down on bad debt

Though some health insurers do offer the service and vendors do provide the technology, real-time claims adjudication remains a pipe dream in most circles, requiring tight integration of practice management systems and payer databases, as well as behavior changes among office staff and patients alike. Yet, with more patients now directly responsible for a growing share of their healthcare expenses, providers are losing untold millions by not collecting small payments at the time of service.

A Minneapolis-based vendor called mPay Gateway is trying to alleviate this problem by applying processes common in many retail settings to healthcare. Hotels, for example, can estimate the room rate at the time of check-in, but don't know the final bill until adding in incidentals such as telephone usage, restaurant charges and mini-bar purchases. The same goes for a physician office visit, where the practice knows what the list price is when the patient shows up, but that estimate doesn't include tests, nor does it account for payer discounts.

"It's that complexity of the billing that's driving the collection problems," mPay Gateway CEO Brian Beutner tells FierceHealthIT.

To address this concern, the company has added an estimation system to a standard credit-card reader. The practice swipes the patient's card at the time of service, then, behind the scenes, mPay Gateway breaks the transaction up into components, requesting an authorization for the full amount of the bill from the cardholder's bank, holding a place in line among other payees for the practice. Once the insurance claim comes back, mPay Gateway requests a settlement on the balance. Typical retail holds on card transactions are 72 hours or less, according to Beutner, but that's usually inadequate for a healthcare transaction that could take weeks to complete. "The [practice] staff doesn't have to intervene," Beutner says.

mPay Gateway has linked its technology to practice management software from Allscripts and from Noteworthy Medical Systems, so the transaction is automatic for anyone with those systems, Beutner adds.

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