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Rete+Pay: Bridging the Gap between Payers and Providers

CIO VendorAsim Ashary, CEO
Having spent a sizeable portion of their careers in the PPO business, the founders of Rete+Pay have carved a niche in providing cost-effective electronic payment solutions to providers by expediting payments and their end cash flow revenue cycle. Rete+Pay seats its wager entirely on its electronic claims payment, funding, and reconciliation solutions that mutually benefit both healthcare payers and medical providers, financially and operationally. Their aim to bridge the gap between payers and providers, and be a “catalyst of change” in the industry spurred the idea of a fully outsourced payment solutions organization, hosting a patented internal virtual card payment program, and other electronic payment models supporting healthcare administrative simplification. “Rete+Pay is a fully matured model and fully outsourced payment vendor to all payers making payments to providers in the group health and workers’ compensation markets,” begins Asim Ashary, CEO, Rete+Pay.

Today, the greatest healthcare-specific challenge is that the resources that understand EDI and claims submission through adjudication and the AP payment process are limited. As a new breed of virtual payment cards and new electronic payment methods are gaining traction, the industry lacks talent or skillsets in the newer payment and remittance technologies—push card, bitcoin, consumer payments, blockchain, and evolving compliance and security. The Rete+Pay team seasoned in the healthcare and financial industries ushers the perfect blend of skills required to address every miniscule detail of the payments and medical claims remittance advice.

To begin with, Rete+Pay’s Provider solution comprises of a virtual, secure, comprehensive and automated system where payers can submit, with no fuss, their existing print vendor file and medical providers will receive electronically generated payments with corresponding remittance advice. Followed by this, the firm’s system leverages proven payment PCI-DSS and SSAE16 compliant technology to process transactions and deliver the claim payment in a secure fashion.
Once the transactions are processed by debit or credit card, the firm’s web portal generates both a scheduled electronic or on demand record of the settlements for easy reconciliation by our Payer Clients. The secure portal can be utilized for payment management, customized reporting, and customer service.

From a security and compliance perspective, RetePay offers provider payments by virtual single-use prepaid debit card, ACH with or without a HIPAA Compliant X12 835 based on the provider’s preference supporting federal regulations, electronic check, or traditional USPS mailed check. “Our company follows all PCI-DSS, SSAE16, and HIPAA standard transactions, privacy and security rules and regulations,” asserts Ashary.

Escorting cost effectiveness in the healthcare claims settlement process, the firm’s Prepaid MasterCard option eliminates manual paper-based payment processes. “The scintillating aspect of this option includes a single use prepaid debit card that cannot be overcharged and it features anti-fraud prevention and security by MCC (MasterCard Category Codes),” Ashary states.

Once a TPA hadn’t entered a PPO contract with a large PHO provider and the TPA’s self-insured client was upset when their members were being charged upfront for services and even surgeries. “Rete+Pay solved the problem by creating a separate virtual card program on the fly the payer to utilize and issue payment to out of network providers, prior to adjudication, prior to the member’s service,” explains Ashary. “This saved the payer’s business and the PHO still does business with that payer due to the solution.”

The strength of Rete+Pay’s robust platform emanates from the seamless communication and visibility across the claims payments process it offers for both providers and payers. “The key is to provide secure and compliant payment methods that benefit both the payer and the provider to reduce overall healthcare expenditures,” extols Ashary.

As investments are adopting new electronic or ‘non-check’ payment methodologies and infrastructure, Rete+Pay happens to be in absolute agreement with this trend and looks forward to expand beyond healthcare virtual payments.