MILWAUKEE – It’s been said that 35 cents out of every dollar spent on healthcare is used for administrative purposes. That’s a heady number, especially to those spending the other 65 cents.
With the idea of speeding up the payment process to increase efficiency and reduce costs, Metavante Technologies has unveiled Healthcare Gateway, a single online portal through which most eligibility enquiries, claims submissions and status checks and payment activities can be handled and monitored.
“Healthcare electronic data and payment interchange adoption can only increase across the industry when eligibility, claims, payment activities and related tools are all available as a suite,” said John Reynolds, president of Milwaukee-based Metavante Healthcare Payment Solutions. “Tools that work together, like those coming together to create Healthcare Gateway, can finally entice providers and payers to move beyond paper-based legacy systems.”
While some vendors offer solutions that link payers and providers or payers and health plans, Reynolds said Metavante is focused on bridging the often-inefficient gap between all three parties.
“The whole effort that we’ve been doing is all around increasing efficiency,” he said. “There isn’t really anything else out there that’s end-to-end.”
Electronic claims submission isn’t new, and that’s something Reynolds is quick to point out. Healthcare Gateway’s purpose is to link eligibility information with claims submission and re-associate post-adjudicated claims payments through a single portal, allowing providers to know which claims are paid, which claims are denied and why they’re denied. Metavante establishes the connections between payer and provider, manages the flow of eligibility and claims information, process post-adjudicated payments through automated clearinghouses and re-associates payments to their original claims.
“At the end of the day, that information needs to be pushed into the practice management system,” Reynolds said, noting that the company is working on interfaces with PM systems and has completed more than 100 so far.
“Healthcare Gateway fulfills the financial cycle for a provider, from the time a patient walks in the door until the provider has been paid and the payment has been posted,” he added. “Additionally, the gateway provides the infrastructure necessary to tap the true potential of combination healthcare eligibility and payment cards, because eligibility claims and payment info flows through the same gateway.”
Reynolds said some 30,000 healthcare providers are now using Healthcare Gateway technology, and another 100,000 are exchanging payments in some form or another through Metavante. He said Healthcare Gateway is being marketed to payers first, and is being white-labeled for large financial institutions “as an opportunity for banks to go in and market a service.”
Metavante recently began trading publicly on the New York Stock Exchange following a completed spinoff from the Marshall & Ilsley financial services company after a 40-year relationship. Metavante delivers banking and payment technologies for more than 8,000 financial services firms and businesses around the world.