Manage third-party payment anomalies for healthcare professionals

Third-party payment is becoming an ubiquitous mode of payment among health professionals, and with its use come anomalies and non-payments that Tiers Payant Assistance proposes to manage. Jean-Michel David, president of TPA tells us more about their job.

What services does Tiers Payant Assistance offer and who is it for?

Jean-Michel David: Third Party Payer Assistance offers two services. The first is the management of third-party payment, 95% of our activity, for all healthcare professionals using this mode of payment to invoice. We monitor this billing and its anomalies on a daily basis. Our second service is third-party payment liability recovery. We intervene on uncollected third-party payment invoicing arrears.

What are the issues related to third-party payment?

Jean-Michel David: The stakes are to collect all the sums advanced by the health professional as soon as possible. Unlike bank cards, checks or cash, where the turnover is collected immediately, with third-party payment, there is a payment period between the moment the invoice is issued and the moment the healthcare professional collects the amount. . Many anomalies, leading to non-payment, can slip through the billing process. The percentage of abnormalities is more or less important according to the categories of health professionals. Our challenge is to manage these anomalies and ensure that the healthcare professional collects the sums owed to him.

How is this market evolving?

Jean-Michel David: It is growing. Third-party payment is becoming the majority mode of payment at health professionals, so the need for third-party payment managers is growing. Third-party payment invoices are not entered in the accounts, therefore it sometimes takes time to realize that the volume of third-party payment generated does not correspond to the sums collected. Economic issues, the decline in profitability, are indicators that today push health professionals to turn to outsourcing this management. In order to raise the awareness of health professionals and to make our profession known, I created a federation, the FNETPbringing together the most important companies in this sector of activity.

How is outsourcing an asset for professionals?

Jean-Michel David: Take the example of community pharmacies. The time spent managing third-party payment internally is multiplied by 4 compared to management outsourced to Tiers Payant Assistance. Outsourcing is the guarantee of recovering employee time for patients, of being paid for all third-party payment billing, of being able to control and control this profit center which represents more than 80% of the turnover. business of an average pharmacy. Poor management of third-party payment can be the source of financial difficulties for healthcare professionals. For a pharmacy, the potential annual third-party payment loss is around 3% of third-party payment turnover. The outsourcing of third-party payment management with TPA secures the collection of 100% of third-party payment for a cost of less than 0.3% of this same turnover.