Baltimore (PRWEB) February 2, 2006
At the core of the Consumer-Directed Healthcare (CDH) movement is the shifting of financial control for everyday healthcare payments from third party payors to consumers. New “account-based health plans” enable employees to use multiple types of CDH accounts simultaneously to maximize tax savings, but employers (and the IRS) may also require substantiation of expenditures. As a result, complex requirements for advanced healthcare debit card technology have surfaced, according to experts at ConnectYourCare.
Account-based health plans introduce a new point-of-service transaction model replacing the old co-pay model with a high-deductible ($1,000 or more) health plan. In lieu of the co-pay for most expenses, consumers are responsible for the cost of a procedure or healthcare item up to the point where their deductible is met. However, they are often furnished with healthcare accounts that are seeded by pre-tax employer dollars, and can add money of their own. Consumers can also make purchases from an expanded list of over-the-counter items (such as contact lens solution and aspirin) with their healthcare account dollars. Health insurance kicks in after the deductible is met, thus providing a safety net. Monies not spent can often accumulate for use the following year.
A new requirement mandated by the evolving nature of account-based health plans is the ability to have multiple health accounts on one debit card, such that multiple healthcare accounts can be “stacked,” including dependent care reimbursement accounts or any employee tax-advantaged health account. Furthermore, a consumer’s payments must be automatically selected from the appropriate account based upon their employer’s plan design, enrollment choices, employee preferences and the expense type; this process is called “multi-pursing”. As CDH evolves to continually enable flexible health plan design, this requirement will become increasingly important when Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs) can roll over year to year.
Early implementations of Flexible Spending Accounts (FSAs), a precursor to CDH, were often tied to a manual, receipt-laden claims substantiation process, which drove low enrollment by only those who could tolerate the administration and long wait for reimbursement. Accordingly, many consumer advantages are inherent in CDH, however, a critical success factor is the consumer experience when paying and being reimbursed for healthcare goods and services from these new health accounts. Debit card vendors must be able to seamlessly manage the logic behind the pursing of accounts in real-time.
The financial services industry is aggressively building products and services in the CDH markets to provide integration points for these requirements as the movement is projected to shift billions of insurance dollars into health accounts and the hands of consumers. As the industry coalesces around the demand, more technology innovation will become apparent at the point-of-service through the smart debit card, such as re-pricing a procedure based on the insurer’s negotiated network discounts. This capability already exists for most pharmacy purchases.
“We have analyzed the consumer purchasing processes in healthcare and applied the most innovative technology available today to each aspect of health account management,” said Jamie Spriggs, co-founder and COO of ConnectYourCare, a leading consumer-directed healthcare (CDH) administrative platform. “Our focus on debit card processing leverages our strategic partners and our own proprietary technology, yielding the highest auto-substantiation rates possible. Employees also have access to an Internet portal to view their accounts and manage HSA investments. If receipts are required, an integrated ‘claims-by-fax’ technology enables a paperless process on our end such that receipts are maintained as digitized images and move through adjudication in real-time.”
ConnectYourCare's benefit delivery platform provides a pathway for migration to CDH, supplying tools for employees to better manage their healthcare choices and a vehicle for employers to realize healthcare cost containment. The ConnectYourCare Solution includes a smart debit card and portal for employees to manage tax-advantaged accounts; claims adjudication and customer support services, and comprehensive medical information and decision-support tools with a focus on wellness. ConnectYourCare sells to midsize and large employers and markets a co-branded ASP solution to health plans, TPAs, banks and investment companies. ConnectYourCare is a Revolution Health Group company. Visit http://www.ConnectYourCare.com for more information or call 1-877-495-3341.
This press release was distributed through eMediawire by Human Resources Marketer (HR Marketer: http://www.HRmarketer.com) on behalf of the company listed above.
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