5 Tips to Improve CHIP Premium Billing

Ensuring accurate and efficient Children’s Health Insurance Program (CHIP) premium billing is crucial to the beneficiary experience and the agency or managed care organization’s bottom line.

There are several strategies these organizations can use to optimize CHIP billing processes. Leveraging automation, user-friendly portals, and a well-rounded payment mix can create a smoother billing experience for your organization and CHIP beneficiaries.

Here’s a look at five tips you can use to improve CHIP premium billing:

Automate Data Validation

Sending poor data into any billing system leads to poor data out of the system. In typical CHIP billing, one system – an eligibility or enrollment solution – sends data to another – a billing system – to generate billing transactions.

Data validation can help ensure the accuracy of your invoices, improving satisfaction and limiting time-consuming manual interventions. Systems that automate data validation naturally improve billing accuracy. That includes leveraging technology to identify data that may be abnormal compared to previous data feeds. It may also include analyzing data to ensure the completeness of records. By automating data validation, CHIP billing entities can create a better billing experience.

Use a Payment Portal

Consumers expect to pay a CHIP bill as readily as any other bill. They want to easily manage payment methods and review past invoices and payments. Plus, the easier it is to pay, the more likely a CHIP beneficiary is to do so. That leads to less work and expense tracking down unpaid premiums, driving down the cost of billing administration.

A well-designed payment portal can achieve those aims. Enabling beneficiaries to make payments, manage their payment methods, retrieve and review current and past invoices, and review their payment history simplifies the payment process while reducing billing administrative overhead.

Simplify Handoffs with Single Sign On (SSO)

Speaking of simplifying the payment process, another way to do that is by integrating billing technology with other technology, like a member portal. Using an SSO process and APIs, you can improve the member experience so they can quickly make payments without multiple logins and use an API to pull in data to display on your member portal.

For example, many of our customers use our API to show beneficiaries their current balance, last payment amount, due date, and other billing information after logging into their member portal. A button click transports them by SSO to our billing portal, where they can quickly pay a CHIP premium bill. The process is seamless for the member.

Automate Delinquency Communications

Late payments happen. Don’t compound the issue by using manual methods to generate and send delinquency communications. Automating that process ensures you maximize your ability to collect late payments while minimizing billing administrative costs.

Look for CHIP premium billing solutions that can automate delinquency communications. Ensure you can quickly modify the template text should your communication needs change. Look for configurable rules that automatically generate notifications based on CHIP requirements like grace periods.

Leverage the Right Payment Methods

Based on our analysis of payment data for those paying Medicaid and CHIP premiums, more than 75% of beneficiaries will pay with a credit or debit card if given that option. Because CHIP premiums tend to be minimal and payment processors base credit and debit card transaction fees on the payment amount, it’s not as costly as you might think for members to pay by card.

ACH payments are the least expensive payment method, so encouraging beneficiaries to pay by recurring ACH should be a priority. Checks can be costly – mostly the labor involved in matching payments to the appropriate account. Our estimates place the cost around $3 per check.

Don’t forget about cash. We introduced a retail cash payment option to a Medicaid population that enables beneficiaries to visit the local Walgreens, Dollar General, or other nationwide retailers to pay monthly premiums. Likely less than 5% of beneficiaries will choose this option, but if you have an underbanked population, that cash option will reduce delinquent payments.

Having a complete payment mix helps maximize on-time payments. Promoting less costly payment methods, like ACH, can help reduce billing administration costs.

Certifi’s premium billing and payment solutions helps automate CHIP premium billing and payment processes to reduce improve on-time payment rates and reduce administrative costs.


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