UnitedHealth simplifies complicated process with online payment

UnitedHealth allows members to pay their bills online as part of its overall focus on simplifying consumers' healthcare experience. Since myClaims Manager launched last July, UnitedHealth members have made more than $20 million in payments using a credit card, debit card or bank account to more than 50,000 providers. What's more, the online payment system continues to grow, with a roughly 25 percent increase in transactions each month.

The success of the online payment system isn't an accident. "This is part of an ongoing evolution within UnitedHealth in which we're trying to simplify the member's healthcare journey," Victoria "Tory" Bogatyrenko (pictured left), UnitedHealth's vice president of product development and innovation, told FierceHealthPayer in an exclusive interview.

"We have spent many, many hours with consumers in their homes, understanding how they experience healthcare, what their challenges are, and during each step of a healthcare life cycle--from picking a plan to finding a doctor to understanding out-of-pocket costs and benefits to seeing that claim--learning where the opportunities are to simplify that experience for them."

FierceHealthPayer spoke with Bogatyrenko to uncover more about how UnitedHealth created the myClaims Manager and how it benefits the insurer.

FierceHealthPayer: Can you explain why UnitedHealth wanted to launch the myClaims Manager system and describe the benefits it provides to the company?

Tory Bogatryenko: First of all, based on historical utilization we know one of the most common reasons people visit our consumer portal is to understand what's happening with their claims--what the claims status is and do they owe anything. But we also have learned through a whole host of consumer research that it's often a challenge for them to understand not only their benefits and why they might owe something but also coding language in the claim they're looking at. So for us, there was a priority to help the consumer become much more informed and really simplify the navigation of their claims.

The tool is designed to make it really easy to understand your benefits, why a claim was adjudicated the way it was and why you owe something. It shows you how the math breaks down. And at the same time, it simplifies the language within that claim in terms that would be familiar to them so they can match that claim back to the experience they had in the doctor's office.

The whole point is to deliver a better experience to the consumer, simplify the way in which they navigate the healthcare system and take one of the most commonly used capabilities that we offer to consumers on our portal and make it a much more useful experience for them.

FHP: Can you describe what is different for a consumer who goes into the myClaims Manager and a consumer who reads a typical explanation of benefits?

Bogatryenko: If you were to open an EOB today, you would see the mathematics, you would see how much the doctor had billed, how much your health plan had paid, the bottom line of what you would owe. You would see the codes for the medical services that you received, but there's not a whole lot by way of explanation.

What myClaims Manager does is breaks down that math and compares it to your benefits. So it will tell you if the health plan paid $100 and how much of a discount that health plan negotiated off of that provider's bill charges. It will then explain what you owe in the context of your benefits--if you have a deductible, what a deductible is and why you might have a bill associated with your deductible. The same would apply to coinsurance or copayment.

What it offers that doesn't exist on any explanation of benefits is a management tool, used much like an online banking program to track claims, mark them as paid and enter notes. The consumer is not only now enabled because they understand what their claims are and what their responsibility might be, but they also can actively manage numbers of claims coming in, what they owe and--what's new to the entire process--pay that claim in the same tool online. It's gone from simply presenting the information to helping the consumer understand that information, managing their out-of-pocket costs and overall healthcare spend to completing the transaction by paying the doctors right then and there.

FHP: How exactly are providers being paid? And how have they responded to the new payment system?

Bogatryenko: The consumer has a number of ways they can make a payment. If they have a UnitedHealth health savings account, they can enter their account information into the myClaims manager tool. We will then, through our processor, issue the payment directly to the provider by taking the money out of the health savings account. Or you can make that same payment using a credit card or you can take the money out of your bank account to send an electronic funds transfer to your doctor.

The tool relies upon providers to register to receive payments. So if a provider registers to receive online payment through the tool, the process is very simple. For nonregistered providers, members can still pay them using the online bill payment system, but it goes through as an electronic voucher the doctor receives with a note encouraging them to sign up to enable everyone to pay them electronically.

Overwhelmingly, what we're hearing from doctors is that they're seeing improved cash flow. People are paying them faster, often because we're presenting the consumer with an EOB before the doctor has even sent a bill. And they're seeing efficiencies around their billing costs.

FHP: How many doctors are registered? And have you received any push back from providers not wanting to register for any reason?

Bogatryenko: We don't track that, but I can say the number is growing every single month. We encourage consumers to tell us if their doctors aren't registered. The tool actually allows them to note that and we collect that information and reach out to those providers to get them on board.

FHP: How have consumers responded?

Bogatryenko: We've had a positive response. Claims payment is one of the highest volume transactions that people perform. We have radically simplified that process for consumers, made it easier for them to understand, given them a tool to manage their claims and out-of-pocket costs, and then allowed them to finish the job by paying a bill with a few clicks. It saves them a ton of time. They've also told us they appreciate the fact that we're listening to their feedback related to health management tasks that take up the majority of their time. We did a lot of consumer research and they're valuing the fact that we're actually walking in their shoes and making that aspect of their healthcare experience a lot easier.

FHP: What has UnitedHealth learned since using myClaims Manager?

Bogatryenko: I would sum it up as bringing the learning full circle to understanding the consumers' experience, understanding the steps they have to take from picking a health plan to understanding their benefits to finding a doctor. We identified those opportunities to make the system simpler and easier to navigate and delivered value to them. It's very important for us to really understand opportunities to make that consumer experience a whole lot better for the individual.

- Dina (@HealthPayer)

Editor's Note: This interview has been edited and condensed for clarity.

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