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Mastercard introduces immediate claims payment process

Virtual cards are embedded within health tech platforms that use API connectivity between payers and providers. 

Susan Morse, Executive Editor

Photo: Image courtesy of Mastercard

Mastercard has announced a medical claims payment partnership in India using its virtual card technology.  

Mastercard has teamed with financial institutions and Remedinet, a cloud-based health tech platform that connects hospitals, insurers and third-party administrators in India. 

The aim is to simplify the backend of cashless claims process by embedding virtual cards within health tech platforms that connect payers and healthcare providers, such as Remedinet, using API connectivity.

Through this embedded experience, the moment the authorized claim is submitted to the insurance company, a virtual card is generated by Mastercard and issued by a financial institution to the healthcare provider. For hospitals or other specialty healthcare centers that previously spent months waiting to receive claim payments, virtual cards provide a critical working capital solution by making the payout process nearly immediate, Mastercard said. 

The virtual claims processing solution is available to all insurance-network hospitals in India on the Remedinet platform. 

It holds promise for the healthcare industry, Mastercard said, though the company stopped short of giving future plans. No one with the company could be immediately reached for comment.  

WHY THIS MATTERS

Integrating Mastercard's virtual card platform makes payments faster, easier and more secure, according to the company that is among the largest payment-processing corporations worldwide. 

The healthcare sector in India is rapidly growing, yet considerable challenges still exist, including fragmentation and lack of digitization, making the country's healthcare system ripe for innovation, Mastercard said.

When asked if the company had plans to expand the platform beyond India, Mastercard released this statement: "Mastercard remains committed to identifying strategic partnerships with large platform providers that will allow us to extend the reach of our payments technologies and drive secure B2B payment experiences around the world."

The B2B process aims to bring relief to providers and insurers strained by the current cashless claim settlement process. Placing virtual cards within the health tech platform also enables detailed transaction-level data to flow alongside the claim settlement information for every bill that is paid with a Mastercard-branded commercial or virtual card. 

This brings several benefits to insurance companies making the claim payment, including greater transparency into the claim status, as well as easier and automated reconciliation.   

THE LARGER TREND

Fragmented, slow and inefficient payment processes have long been a challenge within healthcare. 

Providers have experienced holdups when dealing with claim approvals and payouts, partly through denied claims.

These bottlenecks are amplified by the legacy systems that many insurance companies still rely on to manually process claims. As a result, healthcare providers are often faced with significant payment delays, triggering cash-flow challenges and increased borrowing costs. At the same time, due to manual reconciliation these healthcare providers also lack visibility into the claim-payment status, putting even more strain on their billing teams, according to Mastercard.

ON THE RECORD

"The healthcare industry is at an inflection point, with evolving digital-first expectations challenging industry norms," said Raja Rajamannar, chief marketing and communications officer and president, healthcare, Mastercard. "Around the world, we've been working closely with healthcare organizations to better serve their partners and patients with a range of products and services well-tuned to drive simplicity, convenience and efficiency in payments and beyond."  

"We're thrilled to be the first hospital in India benefiting from Mastercard's innovative solution to improve healthcare claim settlements. Embedding virtual cards within the platform that we're already using to exchange claim settlements with insurance companies is a game changer. Without any technical lift, we're able to receive payments immediately and manage our working capital more effectively," said Dr. Santosh Saklecha, joint director of Santosh Hospital, Bengaluru, the first hospital to onboard the claims process.

Email the writer: SMorse@himss.org