PaySpan Health allows healthcare payers an independent solution to transform paper-based claim settlement environments to electronic claim settlement. Find answers below to questions about the PaySpan Health approach to electronic claim settlement.
- What is PaySpan Health?
- How does PaySpan Health work?
- What advantages are there to using PaySpan Health?
- What makes PaySpan Health different from alternatives?
- How will my providers enroll in the service?
- Is PaySpan Health HIPAA compliant?
- What does PaySpan Health do about remittance details?
- What visibility would we have on payments and remittance advices?
- Will we need to switch banks to take advantage of PaySpan Health?
- How can we get the PaySpan Health service?
- What does the PaySpan Health service cost?
- How long will it take to implement the service?
- Will we need to modify anything in our claims system(s)?
- How do we get our providers to sign up?
- We have significant investments in our existing systems. Will there be extensive modification or integration involved in implementing the PaySpan Health service?
- What are the benefits to our providers?
- What if providers would like to receive EFT payment, but don’t have EDI capability?
1. What is PaySpan Health?
PaySpan Health is designed for healthcare organizations, payers and providers alike, who seek to bring the promise of HIPAA administrative simplification to reality. Specifically, PaySpan Health automates the last leg of the healthcare claims adjudication process – payment and remittance. To accomplish this mission, PaySpan Health optimizes funds transfer and remittance delivery by leveraging HIPAA-standard 835 payment and remittance protocols.
2. How does PaySpan Health work?
Payers communicate the availability of electronic payments to their providers using emails, letters, or other communication methods of their choosing. In the communications, providers are given unique registration codes and the address of the website used for fast online enrollment. With each claims run, payment files are checked against the database of enrolled providers to discern which payments can be made electronically. Enrolled providers receive Electronic Funds Transfers (EFTs) and Electronic Remittance Advices (ERAs). Non-enrolled providers are split off so that checks can be printed in-house or formatted in a file for third party printing and mailing.
3. What advantages are there to using PaySpan Health?
PaySpan Health offers the healthcare industry the first independent solution that transforms paper-based claim settlement to a fully electronic approach. PaySpan Health delivers on the promise of administrative simplification and cost reduction. Transaction fees associated with the service are low and only paid for services used. Using PaySpan Health, payers can save $0.42 or more per claim.
4. What makes PaySpan Health different from alternatives?
Leveraging the inherent efficiencies with EFT payments, PaySpan Health is fast to implement, cost effective, and easy to use. Many alternative solutions can handle only paper or only electronic payment and remittance, whereas PaySpan Health allows healthcare providers to indicate their payment and remittance preference (electronic or paper), building the bridge from legacy processing environments to electronic efficiency. PaySpan Health provides convenient and searchable electronic remittance data, eliminating re-keying of information and calls to payers for remittance reprints.
5. How will my providers enroll in the service?
PaySpan Health provides an online enrollment solution for maximizing provider acceptance of EFT/ERA. Providers can securely enroll in 5 to 10 minutes. Provider support is available should questions arise during the enrollment process. Once enrolled in PaySpan Health’s provider database, any changes to provider information will be managed there, eliminating the payer’s burden of maintaining provider account information.
6. Is PaySpan Health HIPAA compliant?
Yes. PaySpan Health is compliant with the HIPAA 835 payment and remittance standard.
7. What does PaySpan Health do about remittance detail?
PaySpan Health delivers remittance information in an ERA or via a printed advice, depending on provider preference. The availability of remittance advices in an electronic format means that providers do not have to re-key remittance information off of check stubs or PDF images, which reduces errors and saves time in provider reconciliation processes. As an added advantage to this approach, secondary billing can proceed more quickly.
8. What visibility would we have on payments and remittance advices?
All transactions are retained online. PaySpan Health provides unique search and retrieval capabilities against historical data retained online, thus assisting with dispute resolution, payment verification and reprints. Whether the payment and remittance originated in paper or electronic format, all claim and remittance data is retained and searchable online.
9. Will we need to switch banks to take advantage of PaySpan Health?
No. PaySpan Health is bank independent and non-proprietary. You can keep your existing bank relationships and still gain the complete benefits of PaySpan Health.
10. How can we get the PaySpan Health service?
The PaySpan Health service is available directly from Payformance. Call Payformance at 800-733-0908, or send an email to: payspan_health@payformance.com
11. What does the PaySpan Health service cost?
PaySpan Health does not require a software license fee or annual maintenance fee. After an implementation fee, you only pay transaction-based processing fees for each EFT/ERA, making PaySpan Health cost effective, and providing an immediate return on investment.
12. How long will it take to implement the service?
The standard PaySpan Health solution, providing a complete solution for EFT and ERA, can be implemented in 12 to 16 weeks. Custom modifications can be considered following “go live” of the standard solution, and custom projects are quoted on a time and materials basis.
13. Will we need to modify anything in our claims system(s)?
The PaySpan Health solution is flexible and accepts payment and remittance files from payer claims systems in either a HIPAA 835 standard format or proprietary Payformance flat file format. Given these options, payers should not need to modify their claim systems.
14. How do we get our providers to sign up?
Payformance will work with you to define a provider enrollment program that will produce rapid results. We will help you prepare communications to your providers that will encourage them to go to the PaySpan Health site to enroll.
15. We have significant investments in our existing systems. Will there be extensive modification or integration involved in implementing the PaySpan Health service?
No. The PaySpan Health service offering extends the capability of your legacy investments via file transfer. PaySpan Health is flexible and handles payment and remittance files in either a HIPPA 835 format or a proprietary Payformance flat file format.
16. What are the benefits to our providers?
The benefits to providers are significant. For providers EFT and ERA can mean reduced costs, improved cash flow, and fast secondary billings. On cost savings, providers can save $2.94 or more per claim settled electronically. Also, PaySpan Health allows providers to serve themselves – for enrollment, to update profiles, review settlement history, reprint remittance advices, and more.
17. What if providers would like to receive EFT payment, but don’t have EDI capability?
Providers are not required to have EDI handling capability. A great feature of the PaySpan Health offering is the ability to receive and view the ERA online. All that is required is an Internet connection. After receiving email notification of payment, providers can log into the PaySpan Health provider dashboard to view the remittance detail. Additionally, the remittance can be printed locally or downloaded in a HIPAA 835 format.
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1-800-733-0908 
payspan_health@payformance.com
