Real-Time Payments Target Healthcare Benefits Bottlenecks

Within healthcare and human resources (HR) benefits, those frictions remain deeply embedded in the processes that govern payouts.

The most persistent friction points appear in claims substantiation and reimbursement timing. Missing documentation can trigger exceptions that move claims into manual review or automated outreach, extending timelines and increasing complexity.

“Missing or late documentation combined with reimbursement delays creates downstream confusion, more outreach, and additional manual intervention,” Jennifer Whitmire, SVP and head of product for health and benefits at WEX, told PYMNTS.  The interview was part of the “How Real-Time Payments Redefine the Customer Journey” series spotlighting Visa Direct, examining how faster payment rails are being deployed in practical, high-friction use cases.

Those breakdowns are rarely isolated. They connect across the lifecycle of a claim, increasing servicing costs and generating repeated inquiries. For participants, the result is uncertainty about whether funds are moving at all.

Real-time payments are being introduced where timing and certainty are most visible, particularly in reimbursements and corrections. “It’s not about replacing checks or ACH overnight. It’s really about adding that real time as a targeted option,” Whitmire said.

Pressure From Participants and Employers

Participants and HR teams are focused on two questions: when funds will be available and what their current status is. Those expectations are shaped by digital experiences outside the benefits ecosystem, where real-time updates are standard.

“They don’t want to log in, call support, and have to guess what’s happening,” Whitmire said.

Employers face the operational consequences of that gap. Limited visibility leads to higher inquiry volumes and manual follow-ups, adding cost and strain to HR and benefits teams.

Participants also expect immediate clarity around transactions. When a participant uses their benefit cards, they want to instantly recognize and understand the details surrounding the payout, Whitmire said.

Real-Time Payments and the Customer Experience

Faster reimbursements, when paired with visibility, reduce both anxiety for participants and workload for administrators. The impact is measurable across inquiry volumes, servicing touchpoints and reconciliation efforts.

Real-time visibility also changes participant behavior. With immediate prompts and clear status updates, participants are more likely to submit documentation quickly or resolve issues before they escalate.

This shift reinforces trust in the system. Participants gain confidence that benefits are functioning as intended, while employers experience fewer interruptions tied to status checks and manual intervention.

Controls, Infrastructure and Inertia

Speed requires corresponding control. Whitmire said faster payouts depend on upstream validation, fraud safeguards and recipient verification to ensure that payments are accurate and secure.

“You have to know that the payment itself is valid,” she said, noting that “robust fraud and security safeguards” and “clear confirmation and traceability” are essential to maintaining trust.

Legacy infrastructure remains a barrier. Benefits ecosystems rely on a mix of payment methods and rule structures that complicate the introduction of faster digital disbursements. Compliance requirements and operational complexity add to that inertia.

Organizations are responding with incremental adoption. They begin with high-volume reimbursement flows, demonstrate value and expand from there.

Within that approach, WEX is working with payment providers such as Visa Direct to introduce real-time capabilities in targeted areas. The focus is on delivering clarity at critical moments, particularly when participants are waiting for funds or reconciling transactions. Actual fund availability for all Visa Direct transactions may depend on receiving financial institution, account type, region, compliance processes, along with other factors, as applicable.

“Real-time payments really help us reduce that uncertainty,” Whitmire said, adding that the goal is “creating that more transparent experience for our customers.”

These capabilities expand the set of payment options rather than replacing existing methods. Employers and plans can match the payment type to the urgency and visibility required in each situation.

The direction of money movement is clear. Participants expect faster access to funds and immediate visibility into payment status. Employers are seeking to reduce the operational burden tied to legacy processes.

The constraint is not demand but infrastructure. Systems, controls and compliance frameworks must evolve in tandem with payment speed.

As Whitmire put it, the shift is about more than velocity. “It’s about making that process more transparent and self-service with clear statuses, fewer manual steps and faster resolution,” she told PYMNTS.