Payformance pounces on claims process opportunities

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Payformance, a 22-year-old company, was a first-time vendor at HIMSS07 in New Orleans. The company created a healthcare business three years ago. The company lets providers conveniently post and receive electronic payments. “Few people are doing what we’re doing,” said Dan Brown, vice president of marketing.

The company’s customers are health plans, and their providers can come to a secure website and enroll and establish preferences. The system notifies providers about the status of their claims, offering complete remittance details. About 90 percent of the time, health plans are doing this process on paper, Brown said, using 7.5 billion sheets of paper. When considering the paper and postage involved in the claims process, there is a lot of waste. The Payformance solution allows healthcare payers and providers to make complete transactions to electronic remittance advices and electronic funds transfers. “We have invested a significant amount of time and money into the system behind this. It makes no sense for payer IT departments to develop this.” In fact, Brown said most IT staffers are very receptive to this service. With three of the Blues on its client roster, “we are gaining traction in the industry,” he said. “There is a very strong value proposition.” Brown said the potential savings for payers is in the range of 23 to 42 cents per claim. Meanwhile, payers and providers will experience fewer calls about the status of claims. The company also creates an archive so clients can query claims and perform other tasks as necessary.