V-pay is an electronic banking arrangement some third party administrators employ to pay claims. TPA’s are targeted prospects for this lucrative business – http://www.vpayusa.com/pages/healthcare.html

No access fees, no start up fees, no transaction fees are touted as a selling point. But as we know, nothing is ever free. There is a cost of providing services, and someone has to pay for that. Could that be you?

Do TPA’s share in the V-pay revenue stream? If so, how much? 1% of claims, 2%, 3%? If true, a TPA can gain a lucrative, undisclosed revenue stream tied to a percentage of paid claims. For example, if annual claims are $2,000,000, a 1% TPA fee would be $20,000. Not bad money for almost no work.

Editor’s Note: A TPA recently told us they were offered a fee based on a percentage of paid claims to use a vendor’s system to access a V-pay type program. We are in the process of securing documentation of that if it turns out to be true.

From a TPA:

We use two electronic payment services. The first one is through FIS and we pay a few cents per ACH transaction. This was free to providers but we had terrible participation. Very few providers signed up.

Recently we also started using a Vpay/credit card system through PHX which does pay us less than 1%, disclosed to all clients. Wish we did nothing, there is a provider relations element, we get more provider calls then we did before. We have seen far more conversion with hundreds of our providers already accepting this method. No where near the total I would like to see but better then the ACH only option.

It will be a short term industry in my opinion, as soon as more providers sign up for ACH this will go away.

After getting stuck with EDI cost so providers can eliminate their postage cost sticking it back to them was actually one of the selling points.

We have had issues with PPOs, the providers complain to the PPO they aren’t getting their contracted reimbursement.