2022年11月1日

您应该知道的:-为了解决消费者在支付医疗保健时面临的系统性挑战，Cedar(一个改善端到端消费金融旅程的企业医疗保健参与平台)开发了Payer Intelligence Layer。-通过Payer Intelligence Layer, Cedar现在可以集成来自健康保险公司和医疗保健提供者的数据，帮助为管理医疗账单的消费者创建单一信息源。作为医疗保健行业的游戏规则改变者，位于匹兹堡的Highmark Inc.和Allegheny Health Network (AHN)将率先推出新技术，为AHN全资拥有的提供商和设施的Highmark Inc.成员提供服务。在一次医疗保健接触中，典型的消费者可能与他们的提供者和付款人就其访问的财务方面进行多次断开连接的交互。例如，消费者想要支付账单、查看他们的扣除进度或验证他们的健康福利账户余额，可能必须使用多种沟通方法，如电话、应用程序或与供应商和保险公司相关的网站门户。这种不一致导致消费者的沮丧和困惑，导致错过付款、超支、行政浪费和钱留在桌子上的消费者，他们可能不知道他们可用的支出帐户资金。美国消费者每周与医疗保险公司通电话的时间不仅有1200万小时，而且超过三分之一的消费者因为医疗服务提供商和医疗保险公司之间的账单问题而被迫催收债务。为了解决这些系统性挑战，Cedar开发了付费智能层。Cedar的总裁Seth Cohen说:“长期以来，支付人和提供者的不一致导致了消费者管理医疗保健账单的糟糕体验和缺乏清晰度——这是一个系统问题，需要一个系统解决方案。”“当双方各自扮演不同的角色时，双方都无法单独修复体验。 But by bringing both sides together, we can create the best possible experience, reducing billing friction for consumers while delivering more efficient operations for payers and providers.” Initially available with Cedar Pay, the company’s billing and payment solution, the Payer Intelligence Layer enables consumers to access insurance explanation of benefits, real-time deductible status and health benefit accounts in the same place where they view and resolve medical bills—using a single, intuitive interface. Unlike other patient billing solutions, Cedar ensures consumers have the most up-to-date benefits information at their fingertips by directly integrating with health insurers as well as banks, which are responsible for administering health savings accounts, flexible spending accounts and health reimbursement accounts. “Healthcare billing can be fragmented, cumbersome and overwhelming to navigate,” said Neil Kulkarni, vice president, Customer and Clinician Experience Solutions at Highmark Health. “Consumers want clear, easy-to-understand bills for their care and a simple way to pay—with their spending account information available across all channels. As part of Highmark Health’s Living Health model designed to deliver a blended and seamless health care experience, our collaboration with Cedar will help us to meet those customer expectations,” he said. AHN and Highmark are collaborating with Cedar in distinct but integrated ways. Patients who visit AHN providers and facilities will experience the new and enhanced billing, statement and call center process, and simplified access to flexible payment options, all driven by the Cedar Pay platform. For AHN patients who are also enrolled as Highmark members, the enhancements multiply. Beginning at the end of October, the nearly 300,000 members visiting AHN providers will now have the added benefit of having their insurance information incorporated directly into a single billing statement. Members will see how their benefits have been applied, available health spending account funds and their progress towards their deductible and out-of-pocket limits—both when paying AHN bills online, and on the mailed paper statements.