Government Payment Accountability

HealthcarePays is a nationwide healthcare payment network, and the first healthcare payment utility infrastructure in the world to utilize a standardized network to securely move money and payment information between state Medicaid plans, government or commercial healthcare plans, employers, healthcare providers, intermediaries and clearinghouses, and banks.

HealthcarePays is governed by its members, representing the healthcare industry. This ensures the appropriate oversight, and provides all participants the opportunity to join in creating and maintaining a state or national payment infrastructure that will reduce healthcare payment costs dramatically – saving the healthcare industry billions.  Saving millions in state budget dollars.

HealthcarePays automatically re-associates electronic remittance and payments between payers and providers, and systematically distributes payments – accurately and on-time. Waste and fraud are reduced with thorough monitoring, detection of suspicious activity, and timely alerts to the members before payments are made. The HealthcarePays electronic payment services are provided to Medicaid plans and state government payers through a simple, low cost transaction model where only the waste and fraud that is captured, results in any fees to the state. Contact HealthcarePays for more information.

How It Works

State governments can reduce payment processing costs significantly by using the HealthcarePays national network that eliminates multiple transactions and connections for remittance advice and electronic payments. Combine that with real-time reporting and revolutionary waste and fraud detection across the entire ecosystem, and you have a secure payment network that meets the needs of government payers and their constituents.

Benefits for Payers

  • State Medicaid and state employee program waste and fraud reduction
  • Visibility across the payment network ensures transparency for payers and providers
  • Immediate compliance with the Affordable Healthcare Act and all state and federal laws
  • Electronic payment services included in membership
  • Drives provider adoption with free re-association of remittance and payments
  • Multiple payer and provider transactions and connections are simplified to one per-day per-payer
  • Ease of use created by industry standard formats and protocols
  • Latest cloud computing technologies enable scalability
  • Layered world-class security technologies protects data and ensures compliance
  • Data analytics available beyond the state metrics, inclusive of private industry and other states

Network

HealthcarePays connects state Medicaid plans, state employee plans, commercial payers, federal data, intermediaries and clearinghouses and banks to create a network to move payment data quickly and efficiently. It  allows participants the ability to learn from the data, ensure payment transparency and drive waste and fraud from the system by matching the thieves in their ability to attack the system as a whole.

Waste & Fraud

HealthcarePays identifies unusual activity and any abnormal frequency of claims. These claims are blocked and the state is notified BEFORE any potential bad payments are made. The process involves a 3-6 month roll-out of the HealthcarePays state healthcare payment network (State HPN) using the same national technology to ensure state and local payment are processed and examined thoroughly and appropriately.

Participate

Join HealthcarePays today and connect with the only nationwide network, and its ability to institute a state-wide payment network, that re-associates remittance and payments and systematically distributes legitimate transactions. It’s time to tackle Medicaid and state budget-breaking healthcare fraud by using the full ecosystem approach brought to bear by those who’s intent is to steal from the system.