Patient covered by Medicare visits a doctor and gets services done. Doctor bills Medicare for the services provided to the patient.

Medicare processes the bill, sends the payment to their processing company, processing company handles remittance to the doctors office.

The remittance is in the form of a single use prepaid card where the card number and details are FAXED to the doctors office. The office has to manually process this card via their POS and reconcile in their EMR

Everyday that this single use card isn’t used, the processor sends a duplicate fax to the office! This happens every 24 hours. One single use card may also cover multiple claims, so it’s not 1-1 with a visit and can’t be automatically reconciled.

What this means: - The government is basically paying doctors using prepaid gift cards - Doctors pay a debit processing fee just to collect payment - Everything is manual and because of how unstructured the data is, its cheaper to process manually than try to automate

Now imagine how much more complex this becomes when you have multiple clinics with different EMRs. Welcome to healthcare, its a great time!