Payformance Corporation

Payformance Corporation through its PaySpan Health solution creates a value proposition that rapidly and cost effectively transforms paper-based settlements to an electronic environment. PaySpan Health provides all the necessary tools, service, and support to effect this transformation with minimal impact on the Payer, Provider, or member.

Situation

Over $1.5 trillion in healthcare claims is settled annually in the United States. Well over 90% is still fulfilled through the use of paper checks, paper remittance advices, and paper explanation of benefits, and the associated postage. This paper-based environment continues to drive up administrative overhead both for the payers and providers, and ultimately for the members (insured). A paper-based environment additionally creates significant challenges when natural and/or man-made disasters occur.

Solution

Payformance Corporation through its PaySpan Health solution creates a value proposition that rapidly and cost effectively transforms paper-based settlements to an electronic environment. PaySpan Health provides all the necessary tools, service, and support to effect this transformation with minimal impact on the Payer, Provider, or member. In fact, PaySpan Health is one of those rare opportunities when functionality exponentially increases while costs significantly decrease!

Better Health & Lower Costs

PaySpan Health lowers costs, dramatically! Electronic payments and remittance data settlements are so new and few to the Healthcare Industry, there is no significant historical data. That said; through the use of studies performed by national consulting firms, banks, and the payment/data clearinghouses; it has been established that for every one million members Payers can achieve savings in the range of $2.35-$3.25 per member per year. Providers, for that same group of members, can achieve savings in the range of $8.00-$10.00 per member per year. Combined, this equates to over $13 million generated in savings for the healthcare industry per million members per year! With over 250 million insured in the country the possibility exists to take out over $3 billion in healthcare administrative overhead.

During natural and/or man-made disasters, there are no payments or data loses. Funds are secure in the bank, and data is securely accessible from any computer with an internet connection. No recovery, no reissuing lost or destroyed checks, no lost or destroyed remittance advice data forms, no patient personal and private data exposure, no lost cash flow.

Additionally, the ability to direct necessary and need funds to providers in a stricken area continues unabated, since the physical delivery of paper checks and remittance information has been eliminated.

PaySpan Health has comprehensive applicability. It can serve traditional medical, dental, and pharmaceutical care; consumer-directed plans; TPAs; workmen’s comp; Medicaid HMOs; Medicaid; and/or Medicare services. Every niche in the healthcare industry recognized as a payer can benefit from this electronic initiative. Equally true, every niche recognized as a healthcare provider may also benefit from PaySpan Health. Hospitals; doctors; dentists; pharmacies; urgent care facilities; ambulance services; rehab clinics; outpatient surgical units; any and all providers of reimbursable medical/dental care can receive their payments and data electronically, regardless of the sophistication of their back office management systems.

In lowering costs, increasing administrative services and a built-in disaster production and recovery plan; PaySpan Health transforms the healthcare industry claims settlement process.