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Solutions and advisory services for healthcare providers and payers
Millions of patients. Hundreds of insurance plans. Rising healthcare costs. Inefficient claims remittance processes.
At PNC, we have taken a unique approach to helping healthcare providers and payers minimize administrative costs and maximize cash flow.
By combining leading clearinghouse capabilities with premier treasury management services, and over 25 years experience working with healthcare payers and providers, PNC provides a full array of integrated solutions to improve the healthcare revenue cycle. We call it the PNC Healthcare Advantage.
People, Process & Technology
PNC's healthcare experts understand patient billing, finance and technology - after all, we have worked with more than 1,900 healthcare organizations across the country, including payers (2,000 plus connections), providers, pharmacies, Medicare fiscal intermediaries and government agencies. We also provide implementation specialists and an online portal to help automate the revenue cycle and facilitate payer/provider relationships.
Are you a Private Practice?
PNC also offers extensive cash flow options and targeted banking tools and resources to help effectively manage your revenue cycle. To learn more about private practice solutions, visit pnc.com/hcprofessionals.
PNC Continues to Achieve
EHNAC Financial Services Accreditation
You, as a Provider, are facing increasing financial challenges, and protecting revenue is critical. Revenue Cycle Automation solutions help to automate the work flow and the management of your revenue cycle workload. Using Revenue Cycle Automation, you can improve both front-end patient access management activities and back-end denial management processes by applying real-time business rules to the data.
Patient Estimator allows your staff to give patients written estimates of their expected out-of-pocket responsibility.
For Ideas, Insight and Solutions from PNC Healthcare, please visit the Video Library.
We offer transaction processing, denial/payment variance reporting, and business intelligence analytics which deliver benefits across the revenue cycle and support provider’s administration simplification and cost reduction goals.
As a healthcare provider, you need to make the administrative process as easy as possible for patients and more efficient overall. PNC Healthcare is reinventing the way providers manage and collect revenue across the entire revenue cycle to help improve administrative and financial performance.
Collaborating with our clients, we provide customized solutions to:
The services offered include Claim Submission (837), Claim Status (276/277), Electronic Remittance Advice (835), and Electronic Funds Transfer (EFT). PNC continually adds new payer connections to our existing network as healthcare providers move towards 100% electronic transactions. Below is a link to our payer connections for Claim Submission (837), Electronic Remittance Advice (835) and EFT.
If you would like a list of payers for Eligibility (270/271) and Claim Status (276/277), or cannot locate a particular payer in the Healthcare Transactions Payer List accessible below, please contact PNC Healthcare Product Management at firstname.lastname@example.org.
By taking advantage of PNC’s healthcare payment network, payers can streamline the provider enrollment process, reducing the reliance on paper-based delivery. PNC offers automated solutions for disbursing both paper and electronic payments, allowing payers to convert to less costly electronic payments, while integrating with provider reconciliation systems.
Healthcare payers need a way to efficiently disburse paper and electronic payments and remittance information. They also need to work with many different providers across the country. PNC can help payers connect directly to over 600+ providers, reducing connectivity and customer service-related costs.
PNC offers payers a uniquely packaged disbursement solution that delivers remittance information (835/ERA or paper EOB) and payments (ACH, Wire or Paper Check) to their provider network via a single 835/ERA transmission and provider portal.
When it comes to managing liability portfolios in the healthcare industry, standard practice consists of evaluating finance alternatives based upon a comparison of cost of capital followed by an assessment of the risk of each product alternative. Developed by PNC’s Capital Markets group, a new process starts with assessing risk in your healthcare system’s existing liability portfolio.
Many healthcare systems have experienced weakness in financial performance that requires them to examine their current strategies, the adequacy of their information systems and the revenue and cost assumptions under which they were operating. This article shows how successful organizations are addressing these issues.
PNC’s 2016 survey of Healthcare Client Advisory Board members tracks trends in cash posting and associated cost reduction potential. Survey results can help you benchmark your own processes and point the way toward improvement.
Pension plan sponsors are faced with a volatile political landscape that presents significant opportunities and risks. The uncertainty facing the Affordable Care Act is just one of the issues that sponsors will face in 2017 and beyond. Do you have a legacy defined benefit plan, or are you looking at a potential merger where your liability needs to be considered?
Veterans Health Administration (VHA) Teams With PNC to Reduce Administrative Costs
In an industry where only 56% of aggregate claims are paid electronically, the Veterans Health Administration’s eBusiness Solutions team receives more than 85% of its claim payments via Electronic Funds Transfer (EFT). Like the veterans it serves, VHA has achieved its goals through a disciplined approach to its mission.
Beginning in 2003, with PNC’s help, the eBusiness Solutions team began a focused outreach campaign to maximize enrollment of insurance payers for electronic claim payments and remittances (835s).
PNC Epic Case Histories Demonstrate Measurable Improvements
More than 60 Epic clients, representing 20 health systems, presented case studies on Epic integration, shared information and networked with peers in the healthcare industry. During the forum, Penn Medicine presented a detailed case study showing how they automated cash reconciliation by implementing the Epic Cash Management module using custom lockbox files from PNC.
The Miracle of a Proactive Strategy
Denials prevention/management and patient payment estimation/collection are two areas where hospitals have historically taken a reactive approach and continue to fall short from the standpoint of performance. Although providers can correct and resubmit claims, submit appeals to payers, and bill patients 30 to 60 days after their healthcare service has been rendered, these approaches are time consuming and costly. Hopefully, your organization’s approach to these critical functions doesn’t require a “miracle” to get it under control.
The Road Ahead in U.S. Healthcare - Will Patients Take the Wheel?
With the passage of the Affordable Care Act and other recent trends in the U.S. healthcare system, we are experiencing a paradigm shift toward patient-centered care. PNC Healthcare commissioned Shapiro+Raj to explore this shift and what it means for the future of healthcare. This white paper summarizes the results of their study.
The Frugal Healthcare Provider - Saves and Earns with PNC's P-Card Program
Shannon Medical Center in San Angelo, Texas, has served the Concho Valley for more than 80 years. Today it is licensed for 400 beds and is the designated lead level 3 trauma center for the region. The locally-owned health system has a nationally-recognized intensive care unit and critical care for fragile newborns is also among its many services. In order to continue to grow and deliver the state-of-the-art services its diverse community requires, the hospital has maintained the frugal nature of its founders, J.M. and Margaret Shannon. Shannon’s Board of Directors keeps a laser focus on the bottom line.
Healthcare Advisory Board Update
With the passage of the Affordable Care Act and other recent trends in the U.S. healthcare system, we are experiencing a paradigm shift toward patient-centered care.
Healthcare Virtual Card Payments — Just the Facts
Healthcare regulations continue to focus on ways to reduce cost and increase efficiency for both Providers and Health Plans, including a renewed emphasis on electronic payments. Electronic Funds Transfer (EFT) payments sent via the ACH Network are now considered a HIPAA transaction; therefore, Health Plans are required to provide EFT payments if requested by a Provider.
Are You Ready for Chip Cards?
In October 2015, a new technical standard for credit cards will be introduced. The standard is also known as Europay, MasterCard® and Visa® or EMV, after the developers of the technology. It is designed to ensure that microchip-embedded payment cards (chip cards) are compatible with the terminals of merchants who accept them.
PCI DSS: The Security Your Customers Are Looking For
Cybercriminals are just like any other criminal — they prey on the weak and vulnerable. And they are discovering that many small merchants have not implemented even the most basic security measures.
Get to Know Greg Jelinek
In October, 2014, PNC Healthcare welcomed Greg Jelinek as our new executive vice president.
PNC Healthcare Answers your Questions about Health Savings Accounts
Health Savings Accounts (HSAs) are not entirely new, but are receiving greater scrutiny today in relation to high-deductible health insurance plans and the Affordable Care Act.
Foundations and Investments: An Overview of the 2013 NACUBO-Commonfund Study of Endowments
On the surface, it seems as if the endowment and foundation world is a poster child for successful investment management. Generally speaking, returns from endowments have been strong over the past decade despite historically low interest rates and recently slow economic growth. However, a deeper dive into the data reveals several challenges within some parts of foundations and endowments.
Questions to Ask When Selecting a Money Manager
Investment performance data on money managers is readily available, but it takes time and expertise to critically evaluate and identify those investment managers who most effectively satisfy your specific financial objectives.
Financing Options for the New Healthcare Environment
In this environment, changes to existing payment models and delivery systems will put additional pressure on operating margins and cash reserves. Consequently, healthcare providers will need to re-think access to capital from traditional and non-traditional sources.
Gambling with Healthcare Payments
The Office of Management and Budgets estimates the aggregate impact of the Medicare portion of the sequester to be $11.35 billion in Fiscal Year 2013. That's just one of the impacts.
Reconciling Patient Payments Across a Multi-Site Physician Practice
After revamping how it manages patient payments, Jefferson University Physicians, a multi-site Philadelphia physician practice is now identifying deposit discrepancies within 24 hours.
PNC Healthcare Client Advisory Board Updates:
Cash Posting Survey and Opinions on ICD-10
At the December meeting of the PNC Healthcare Client Advisory Board, some of the nation's largest healthcare providers discussed revenue cycle projects, reviewed PNC's product strategy for 2014, and shared detailed plans for mitigating the impact of ICD-10.
Worried About ICD-10?
Now that you have an extra year to prepare, here are some additional steps you might consider to improve ICD-10 readiness.
Latest National Economic Outlook:
PNC's economists publish a variety of reports that provide analysis and forecasts of national, regional and global economic and financial trends.
Learn More »
Cybercrime: Commonsense Precautions To Protect Your Organization
Dozens of botnets have helped thieves heist more than $100 million from the accounts of businesses around the world. Hackers stole more than $1 million from the payroll accounts of a Washington State hospital. Understanding the tools and methods these fraudsters use can help you protect yourself and your organization.
Are Reconciliation Issues Draining the Life from your A/R Staff?
Help from CAQH CORE Rule 370 is on the way.
CAQH CORE Rule 360 Clarifies CARCS
These regulations take an important step towards standardizing the content of the 835, making it easier for providers to automate business processes and reduce effort needed for follow-up and secondary billing.
PNC Launches 837 Claims Submission Services for Providers
Due to today's economic and regulatory pressures, healthcare providers need to identify every opportunity to achieve administrative cost savings. PNC has launched an HCA Claims Submission service to address these challenges.
Major Payer Finds PNC's Remittance Advantage has "Something for Everyone"
A major healthcare payer in the Northeast sought a more efficient system for managing payment cycles, remittance advice and payment details that would be easy for even technologically unsophisticated providers to utilize. Particularly important was the ability to convert proprietary file formats to 835s and to create matching electronic payment.
PNC Healthcare Client Advisory Board Discusses 2013 Priorities, Surveys Automation Success Stories
PNC clients participate in a number of Advisory Boards, helping PNC to evaluate new product concepts and to improve service by defining quality measures that are meaningful to clients.
PNC Healthcare Ideas
The healthcare landscape is undergoing the largest transformation in its history, fueled by regulation, the need to reduce costs, and the demand for transparency. PNC Healthcare Ideas provides insight and solutions to help healthcare professionals drive efficiency, profitability and keep ahead of change. Look for a new idea every other month.
Browse our PNC Healthcare Ideas videos »
U.S. Healthcare Efficiency Index (2013, revised May 2014), p. 18.
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Banking and lending products and services, bank deposit products, and treasury management services, including, but not limited to, services for healthcare providers and payers, are provided by PNC Bank, National Association, a wholly-owned subsidiary of PNC and Member FDIC.
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