Last week, New York-based JPMorgan Chase announced it acquired the assets of FisaCure (Carrollton, Texas), a provider of electronic remittance services for Healthcare Insurance Portability and Accountability Act (HIPAA)-compliant transaction sets. The move brings FisaCure's expertise in this area into the bank's Healthcare Solutions unit, which is part of the firm's treasury management business.
Yet JPMorgan Chase and FisaCure are not strangers to one another. The bank began partnering with the remittance provider in 2006. It originally private labeled the FisaCure service. With this purchase, FisaCure is now officially wholly owned and operated by JPMorgan Chase, explains Alberto Casas, VP, JPMorgan Chase Healthcare Solutions. "This acquisition lets us onboard their technology and control our destiny regarding its development," he says.
The bank had been offering healthcare solutions for some years. However, FisaCure gives it some added capabilities that are anticipated to bring value to the healthcare clients. According to Casas, this gives JPMorgan Chase an opportunity to bring more efficiency and simplification to the healthcare community—to insurers, and doctors and hospitals. He says that although there is some automation in terms of the exchange of data to insurers for reimbursement, things are still largely paper-based in the healthcare industry. "What's not automated is the actual payment on the payer side and the reimbursement on the provider side," he says. "They're dealing with paper checks and explanation of benefits. The biggest challenge is that every insurer has its own format and rules so it's difficult to automate this."
This is where FisaCure's expertise comes in. The firm's solution can digitize paper, such as checks and explanation of benefits statements, using intelligent character recognition technology. The company created a library of hundreds of templates that can distinguish between the claims forms of various insurance providers. "It knows where to look for data on these forms, it reconciles what's submitted from what's received," relates Casas. The system takes the image of the EOB and check, lifts the data from the paper and develops custom rules specific to each provider's practice management system. It then sends the transaction to the provider in a format the insurer can read, whether standards-based or proprietary.
Although HIPAA was passed to help enact some standards in the healthcare industry with regard to the transmission of data (in addition to the privacy protections it provides), it has been a challenge to make these standards a reality since many payers have multiple legacy systems with which they handle payments. As a result, getting the healthcare industry to embrace e-payments has been somewhat of an uphill battle, according to Casas.
JPMorgan Chase first rolled out the FisaCure services on the provider side to help facilitate the automation of their files. The next step will be to get the payers on board with electronification. "Our goal is not to continue to support paper processes but to try to work with payers on behalf of the providers to migrate them to electronic payments. So we'll leverage our relationships with the payers to do this. The payer community is starting to realize there are significant benefits to moving away from paper. We ultimately want to create simplification in the industry on both sides."
So far, the response from the provider side has been very encouraging, Casas says. "The providers are very excited about automating paper processes. They're migrating to electronification at a more rapid pace now than they would have on their own. It's a real value proposition to them and the industry in general."
The bank ultimately plans to integrate the FisaCure technology into its suite of services. "The plan is to integrate while not overly reengineering the process," Casas explains. "We just want to onboard it into our structure." FisaCure employees will be moved to a JPMorgan Chase facility in Dallas. Many in the financial services industry are beginning to realize the wealth of opportunities awaiting them in the healthcare field. "In some cases, the paper and data don't always travel together, making it difficult for providers to manage," Casas says. "Banks are uniquely positioned to add value to the claims submission process. They are the first point of contact for both information and payment. We receive both and are able to reconcile both for clients. This eliminates manual steps on the provider side. At JPMorgan Chase, we want to create a value chain solution for the entire process—from the point of interaction at the patient end through submission of that claim."