Healthcare Finance Leaders’ Guide to Straight Through Processing
Key Takeaways
- Straight Through Processing (STP) automates virtual card payments from “approved” to “deposited + reconciled,” typically in about one day instead of 60–90 days.
- STP is purpose‑built for healthcare, handling both insurer (B2B) and patient (C2B via payer portals) flows while feeding clean remittance data into the platform and your revenue tools.
- The solution is designed for HIPAA, PCI DSS and HITRUST‑aligned environments, and runs behind the scenes without forcing disruptive changes to your EHR or practice management stack.
Healthcare finance leaders sit at a difficult intersection. You’re responsible for keeping operating margins in the black while also staying true to the organization’s clinical and community mission—and increasingly, those goals are in tension.
Margins are improving in some markets, but they remain thin and uneven. At the same time, more revenue is tied to patient responsibility, where collection rates continue to fall. The bottom line: every dollar that sits in flight instead of in your operating account adds volatility you can’t afford.
This is exactly where Straight Through Processing (STP) can change the equation—by compressing the time from insurer approval to provider deposit of virtual credit card payments from up to 60 days to roughly one day, and by stripping out the manual work and risk that come with mailed virtual cards.
The new realities behind your payer mix
On paper, payer mix still looks familiar: Medicare, Medicaid, commercial and self-pay summarized neatly on the income statement. But the cash story behind that mix has shifted.
High-deductible plans and rising out-of-pocket costs mean more of each encounter’s total charge now falls to the patient after insurance, not just to the insurer. Those patient-owed balances are far harder to predict and collect than contracted insurer payments, and many organizations are recovering only a fraction of what’s billed on the patient side. The result:
- Less predictable cash flow, as a larger share of revenue depends on patient behavior instead of institutional payers.
- Higher write-offs, with bad debt and charity care climbing as affordability challenges grow.
- Greater sensitivity to delays on the “reliable” side of the mix—your insurer reimbursements must do more work to stabilize cash.
Against that backdrop, it’s no longer enough to optimize only patient collections. To protect margin and mission, healthcare finance, IT and operations leaders need to accelerate every predictable dollar.
Where should you start? The lowest-hanging fruit is payer reimbursements.
How virtual credit card payment automation accelerates cash flow
For many organizations, insurer reimbursements still arrive the hard way: Payers issue virtual cards for approved claims and send those card details through the mail, leaving providers to finish the last mile manually.
That “status quo” workflow looks like this:
- Letters arrive at the practice or lockbox.
- Staff open and sort mail, retrieve virtual card details and key payments into a terminal or practice management system.
- Teams reconcile deposits and remittance data days or weeks later, often by hand and often across multiple systems.
On paper, it’s a digital payment. In reality, it’s a paper-era process with familiar consequences: extra administrative work, slower access to cash, more opportunities for fraud or loss and a wider PCI DSS footprint as staff handle card numbers directly.
Those pain points set the stage for a different approach: automating the entire path from virtual card creation to deposit and reconciliation, without changing how payers adjudicate claims.
What is Straight Through Processing?
STP is a payment automation process offered that allows healthcare providers to receive payments from insurance companies and from patients (via their payers) in about one day, directly into their bank accounts.
Instead of sending virtual card details through the mail and relying on manual posting, STP:
- Keeps the virtual card model at the payer level: The insurer continues to generate a virtual card (VCC) for each approved reimbursement or patient balance, just as they do today.
- Routes those virtual cards electronically to CSG Forte: The insurer sends the VCC details and remittance data to CSG Forte over secure, encrypted channels.
- Automates virtual credit card payment processing and deposit: CSG Forte processes the virtual card and deposits funds directly into the provider’s bank account—typically the day after the claim is approved, instead of weeks or months later.
- Delivers complete reconciliation: Payments and remittance information are surfaced in CSG Forte’s platform so your finance and operations teams can track, match and report on every transaction efficiently.
From your team’s perspective, reimbursements simply show up as electronic deposits with clean remittance data, without anyone handling plastic, paper or card numbers.
How STP fits into your insurance and patient payment flows
For healthcare administrators, IT and revenue cycle leaders, it helps to see how STP aligns with existing claim and billing processes.
At a high level, two flows benefit: B2B (payer → provider) and C2B (patient → provider via payer).
1. Insurance (B2B) payments
- A patient receives care; the provider submits a claim.
- The payer adjudicates and approves a portion—for example, $110 on a $200 visit.
- The insurer generates a virtual card for the approved amount and routes it electronically to CSG Forte.
- CSG Forte processes the VCC and deposits the $110 directly into the provider’s bank account, usually within one business day of approval.
- CSG Forte’s web platform presents the payment and associated remittance data so your team can post, reconcile and report without rekeying or guesswork.
2. Patient (C2B) payments via payer portals
- After insurance, the patient still owes, say, $50 (copays, deductibles, coinsurance).
- The patient pays their balance through a payer-linked portal using an HSA/FSA or other card.
- That payment hits the insurer’s engine, which again creates a virtual card for the $50 balance and sends it to CSG Forte.
- CSG Forte processes the virtual credit card payment and deposits the $50 into the same provider account, with remittance data aligned to the patient and claim.
By centralizing both flows through STP, you:
- Reduce manual touch points.
- Gain a more predictable view of insurer and patient cash.
- Create a cleaner foundation for downstream patient billing and collections.
From mailed cards to automated deposits: the STP advantage
Replacing mailed virtual cards with straight-through electronic deposits unlocks a set of concrete advantages across finance, operations and compliance.
1. Faster access to cash: Moving from up to 60 days of mail-based reimbursement to roughly one day after approval has a direct impact on days in A/R and days cash on hand. That acceleration can:
- Smooth intramonth liquidity swings.
- Reduce reliance on short-term borrowing or internal juggling.
- Support more proactive decisions around staffing, capex and growth.
2. Lower administrative burden: With STP, your teams no longer need to open envelopes, key card numbers into terminals or manually match deposits to remittances. Our platform consolidates payment and remittance data so staff can focus on exception handling instead of transactional data entry. In an environment where revenue cycle and billing roles are hard to staff and retain, simplicity significantly increases efficiency for lean teams.
3. Reduced fraud and loss exposure: Automated virtual card processing significantly reduces the surface area for:
- Intercepted mail and stolen card details.
- Card testing fraud on exposed numbers.
- Misapplied or lost payments that never make it to your deposit account.
By keeping sensitive card data within encrypted, controlled systems and eliminating physical mail, STP helps lower your fraud and loss risk while improving traceability.
4. Stronger security and compliance posture: CSG Forte’s healthcare payments capabilities, including STP, are designed to support high standards of HIPAA, PCI DSS and HITRUST-aligned security controls. Because your staff are no longer handling card numbers directly, your PCI scope is narrower and easier to manage and your audit trail for payer remittances becomes more robust.
Ensuring compliance and security in payment automation
For healthcare administrators and operations leaders, the value of STP isn’t just “faster payments.” It’s a set of strategic improvements in:
Finance and revenue cycles
- Cash flow acceleration: Shorter reimbursement cycles stabilize liquidity and free working capital for strategic initiatives, not just firefighting.
- More predictable revenue: With insurer and payer portal payments flowing directly to your accounts, forecasting becomes more reliable.
- Cleaner close: Automated posting and reconciliation reduce end-of-month surprises and manual journal entries.
IT and data teams
- Fewer brittle customizations: STP runs behind the scenes handling the virtual card processing; your core EHR and practice management systems don’t need invasive changes.
- Better data quality: Consistent remittance data that is aligned with deposits and supports more accurate analytics and reporting across payer, specialty and facility.
- Security by design: Centralizing virtual credit card payment processing with a healthcare-ready payments partner helps you align with existing security and risk frameworks rather than creating new exceptions.
Operations and practice leadership
- Staff efficiency: Each remittance that posts automatically is one fewer piece of paper to touch or spreadsheet to reconcile.
- Less burnout from repetitive work: Reducing tedious, error-prone tasks makes it easier to retain experienced revenue cycle and billing staff in a tight labor market.
- Alignment with long-term automation strategy: Industry research continues to highlight significant savings potential from automating administrative processes across healthcare finance. STP supports your broader automation strategy.
Moving from 60 days to 1 day with CSG Forte
Healthcare providers can’t afford to leave cash flow to chance—not when margins are thin, patient affordability is under pressure and labor markets are tight. Optimizing patient collections will always matter, but stabilizing the predictable, contracted side of revenue is just as critical.
CSG Forte’s Straight Through Processing gives healthcare finance, IT and operations leaders a practical lever to:
- Replace mailed virtual cards with automated deposits.
- Shorten reimbursement cycles from months to roughly a day.
- Reduce fraud and compliance risk tied to manual card handling.
- Free staff from low-value, high-volume tasks.
All while working within the payer and portal ecosystems you already use. STP does not require changes to payer adjudication or your core EHR/practice management systems.
Ready to learn more? Connect with experts from our team to see how STP can fit into your healthcare payment workflows and revenue cycle strategy.
Frequently Asked Questions
FAQ 1: What is virtual credit card payment automation in healthcare?
Virtual credit card (VCC) payment automation replaces mailed virtual card letters and manual keying with a fully electronic flow from payer to provider bank account.
In the STP model, payers still generate a virtual card for each approved claim or patient balance, but they send the card credentials and remittance data directly to CSG Forte over secure channels instead of sending paper to your office.
CSG Forte then processes those cards automatically, deposits funds to your account (typically the day after approval) and surfaces the associated remittance data so your team can post and reconcile without touching envelopes or terminals.
FAQ 2: How does CSG Forte’s STP differ from ACH or check‑based payments?
Check-based and many “virtual card by mail” workflows rely on postal delivery and manual keying, which can stretch the window from approval to deposit to 30–90 days and consume significant staff time.
ACH EFT can eliminate paper but often still requires a separate process to match deposits with remittance files and handle exceptions. STP focuses specifically on virtual card reimbursements: it automates the last mile from “virtual card issued” to “funds in your bank with matched remittance,” so you get the speed and card-rail protections of VCCs with far less manual work.
Many groups pursue ACH and STP together—using ACH where they can, and applying STP to the substantial volume of virtual card payments that won’t go away in the near term.
FAQ 3: Is STP available for all payment types and payers?
Today’s STP offering is focused on automating virtual card reimbursements, covering both insurer payments and patient payments made through payer-linked portals (e.g., HSA/FSA spend).
Within that universe, you can choose whether to enroll only insurer (B2B), only patient (C2B) or both flows, and you can route them to the appropriate bank accounts.
STP does not currently turn every payer or every payment method into a straight‑through flow, but it gives you a high‑impact way to automate a large and growing slice of card-based reimbursements without waiting for every payer to move to ACH.
FAQ 4: What compliance and security standards does STP support?
STP is designed to operate within HIPAA, PCI DSS and HITRUST‑aligned security frameworks, reflecting the dual sensitivity of payment data and protected health information (PHI).
Card data and remittance information move through encrypted, access‑controlled systems; staff no longer handle card numbers directly, which helps narrow your PCI scope and strengthens audit trails for payer remittances.
On top of that, our platform provides role‑based access, MFA, IP whitelisting and detailed logging so finance, IT and compliance teams can enforce least‑privilege access and reconstruct who did what, when and why.
FAQ 5: Does STP require changes to my EHR, practice management or RCM systems?
STP is intentionally designed to run “behind the scenes” so you don’t have to rip and replace core systems to benefit from automation.
Virtual card processing and data normalization happen on the CSG Forte side; you can start by centralizing acceptance, settlement and reconciliation and then deepen integrations into your EHR, PM or RCM tools over time.
Many organizations use STP to stabilize cash and clean up remittance data first, then work with their internal teams and vendors to map that cleaner data into existing posting workflows rather than rebuilding those workflows from scratch.


