Fallon Community Health Plan will implement PaySpan's automated payments platform for enrollment, reimbursement and other transactions in line with new rules tied to the Affordable Care Act.
PaySpan, which provides payments technology and offers a "health care wallet," will supply transaction processing and ensure Fallon's payments comply with EFT/ERA Operating Rules under new health care law covering remittance and electronic funds transfer. Fallon serves Medicare and Medicaid users through a mix of programs, including Fallon Total Care, a new program that provides health care for people 21 to 64 years of age who are eligible for both Medicare and Medicaid.
"Implementing PaySpan's EFT/ERA solutions will optimize efficiencies and bring a new level of value and convenience to our providers, specifically in enhancing transparency, simplifying payments and reimbursements and, in particular, better managing dual eligibles, which are among the most costly and complex beneficiaries of healthcare services," said Rick Commander, senior vice president and chief operating officer for Fallon Community Health Plan, in a release.
The new health care law is expected to lead to a boom in payments technology adoption, since compliance relies heavily on automated processing and electronic commerce. There's also opportunity for companies that organize medical billing, as Patientco and Simplee are doing.