Visa going direct into health payments market

Visa going direct into health payments market

Summary: Visa emphasized that the system allows hospitals to guarantee payment at the point of care, noting that as many as 50% of all bills go unpaid.

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Visa announced a deal with Preferred Health Technology of Carrollton to push PHT's A-Claim payments system to insurers and hospitals, based on the Visa brand.

A-Claim offers insurers an interface that checks eligibility and automatically calculates payments based on the patient's plan.

This does not mean patients must settle bills with Visa cards, but it could put the Visa logo onto insurance cards and run payments through Visa's processing system.

The deal is big for both sides. It puts Visa directly into health care payments. It gives PHT a big partner it can use to secure deals with insurers and hospital networks.

Visa emphasized that the system allows hospitals to guarantee payment at the point of care, noting that as many as 50% of all bills go unpaid.

Hopefully this can also eliminate the common hassle of patients getting tiny bills from hospitals for treatments received weeks or months before, after they have been run through the insurance system. The A-Claim solution promises to run those payments through Visa automatically.

Topics: Health, Banking, Enterprise Software

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5 comments
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  • Have some pie

    This is "pie in the sky". I have worked in managed care since 2002 collecting for hospitals from all the insurers, self-funded ERISA and other plans that approve treatment and then don't pay.

    Every carrier and plan reads a disclaimer which says basically, "Certification is not a guarantee of payment. Eligibility is determined when the claim is received."

    There is also the problem of retroactive cancellations. For instance, someone just left his job and the insurer/plan hasn't been told, so it "verifies benefits", and then weeks or months later is told the person was not employed and there was not coverage. If the insurer/plan has paid it demands a refund. If the provider refuses, the insurer/plan "recoups" by offsetting the amount against other monies the plan owes.

    Most networks/insurers draft their own managed-care contracts which include something to the effect that if the person is not covered, the provider bears the risk, not the payor, e.g., the person signs up for insurance, gets the card, and then stops paying premiums.
    Rick_R
    • That's why Visa was so slow getting into it

      It takes a lot of interfaces to get into this
      business, and building those interfaces is A-
      Claim's business.
      DanaBlankenhorn
  • As long as it excludes the patient

    The concern I have is that somewhere in all the
    forms you sign when going into hospital will be
    some small print setting you up with a Visa account,
    with 30% interest.
    Ken_z
  • RE: Visa going direct into health payments market

    My organization is going to LOVE this. I can get payment now upfront? If so this will reduce the costs of mailing out bills every month that are being thrown in the trash anyway!

    Every other industry is doing this, its about time we can do it now in medical...PERFECT

    mmic
  • RE: Visa going direct into health payments market

    We are an A-Claim reseller. You can see us at http://www.2cpusa.com/html/aclaim.htm

    We are offering A-Claim for FREE trial for 1 month, no obligation.

    There is a flash demo there. We can be reached via email at sales@2cpusa.com.
    2cpusa