HPS PROVIDER BLOG

PayMedix is our innovative payment platform that guarantees payment to providers, credit to patients, and simplicity for all.

PayMedix is our innovative payment platform that guarantees payment to providers, credit to patients, and simplicity for all.

Catching Up With HPS

Over the last year, the HPS team worked together to push through a year that no one predicted. HPS quickly stepped in to help our partners any way we could including suspending timely filing requirements for many of our provider partners whose business offices were hit especially hard by COVID-19. Due to the financial struggles of some of our members, we provided additional financial support for patients who needed more time to pay. Here are some highlights from an unprecedented year.

Here are some of the ways HPS continued to achieve that goal over the last year while serving  our providers.

Market-Leading Performance for Your Patients

Over the past 12 years, HPS has made significant strides in medical billing that has helped us navigate an unprecedented time in modern health care 

Since 2008, HPS has:

  • Processed more than $4.3 billion in total medical bill charges
  • Assumed $270 million in patient responsibility
  • Benefitted more than 87,000 families

SuperEOBs Thrive

The HPS SuperEOB is an easy-to-read statement that consolidates all of an individual’s or a family’s in-network explanations of benefits and medical bills for an entire month, regardless of how many doctors they met with. This breakthrough statement system is designed to empower consumers to evaluate and take control of their medical expenses. Consumers love it! It simplifies the billing experience and is environmentally friendly. To date, HPS has generated more than 2 million monthly SuperEOBs – avoiding over 3 million additional pieces of mail related to the same healthcare services.

In addition to these efforts to improve healthcare billing systems, HPS continues to offer consumers:

  • One place to call for customer service 
  • Interest-free financing payment plan options
  • One online billing experience
  • Advocacy navigating the healthcare billing & payment experience

Single Payment Solutions

According to Milliman’s 2020 Medical Index Report, the average family of four spent $4,582 in out-of-pocket expenses in 2019. 

HPS continues to provide a single-payment option that includes out-of-pocket expenses to all participating providers. We expect that competitive pricing will allow HPS to continue to move more of your receivable dollars to the single-payment solution. 

HPS currently holds $6.9 million on interest-free financing plans benefitting more than 2,500 members.

Collection Rates

HPS is seeing positive results from its payment solutions that improve collection rates overall. 

HPS’s collection rate of patient out-of-pocket costs continues at approximately 85 percent, while the national average hovers around 50 to 70 percent of a patient’s bill after a doctor’s visit. 

HPS providers also enjoy strong cost benefits from smooth claims processing that includes fewer denials. 98 percent of all HPS provider claims are repriced, processed, and paid accurately the first time without any claim adjustment. 

Exciting Updates For Members

The HPS of 2021 is dedicated to expanding its network, solutions, and enhancements with: 

  • Statewide network expansion

HPS continually seeks to improve its Wisconsin health network by adding new providers, improved pricing, and cost-saving solutions such as telemedicine and bundled payments for common procedures.

  • An expanded proprietary SuperEOB format 

Consumers desire easy-to-understand medical bills and we plan to deliver that to even more consumers in 2021. One of the most troublesome problems in American healthcare today is billing. HPS aims to fix this breakdown in the medical billing system by growing the use of SuperEOBs.

  • Improved member portal enhancements including an online payment portal

With 82 percent of consumers preferring to make all their healthcare payments in one place using streamlined payment experiences, including electronic, online, and automated, HPS will make even more patient-centric enhancements to its member portal.

Welcoming an Investment In Growth

In early 2021, HPS announced that SV Health Investors, LLC acquired a majority stake in the Company, and Hexagon, Inc., a private investment company and one of SV’s limited partners, invested in HPS alongside SV.

This transaction provides growth financing for HPS and placed Tom Policelli, SV Executive in Residence, as CEO of HPS and Terry Rowinski as the company’s President.

HPS Community Involvement

Each year we participate in the LLS Light the Night Walk. In honor of HPS founder James Brindley, who was diagnosed with leukemia, HPS employees fundraised and donated to the Leukemia & Lymphoma Society. The team represented HPS during the 2020 Virtual Light the Night Walk, which invited fundraising walk teams to come together online.

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