AMCNO Supports Multi-Payer Web Portal Initiative for Physician Claims

 Availity to Offer Training Conference in Cleveland

Recently the Academy of Medicine of Cleveland and Northern Ohio (AMCNO) announced our full support of the plan to launch a multi-payer portal project in Ohio . This landmark initiative is meant to make delivering and getting health care easier for patients and their physicians by reducing the time, effort, and expense for the paperwork required for each office visit. America ’s Health Insurance Plan (AHIP) and Blue Cross Blue Shield Association (BCBSA) have brought their members plans together in an effort that is designed to address the needs of Ohio physicians and patients to make health care office visit procedures simpler by streamlining and fully automating key office tasks.

Health insurers across the state of Ohio have launched a multi-payer web portal to assess how best to offer physicians access to multiple insurers through the same channel of information exchange (e.g., a web portal) for the purpose of conducting office tasks. The web portal is provided free of charge to physician practices by the vendor Availity.

It offers opportunities to simplify the work associated with patients visits and achieve savings, streamlining the administrative process for physician practices by providing information in “real-time” that:

* Allows office staff to quickly determine key eligibility and benefit information (e.g., co-pays, co-insurance and deductibles, and differences in coverage for services provided in- versus out-of-network), minimizing the number of staff needed for such purposes;
* Gives physicians access to current and accurate information on the status of claims submitted by physician offices for payment by insurers. This will minimize the need for follow up steps by office staff or submission of duplicate claims that delay rather than expedite payment in most systems;
* Tests real-time referrals and timely pre-authorization of services; and
* Provides for the online submission of a health care claims.

The health plans participating in the initiative in Ohio are Aetna , CIGNA, Humana, UnitedHealthcare, Anthem Blue Cross and Blue Shield, WellCare Health Plans, Inc., and Medical Mutual of Ohio.

Insurers are partnering with local physician organization, like the AMCNO, to ensure the progress can be monitored and specific issues can be addressed directly. The AMCNO is one of the many physician organizations supporting the effort and we plan to work to encourage our members to take part in the initiative. The AMCNO has been a strong proponent for reducing the administrative tasks that physician offices face when processing insurance claims and we have supported legislation meant to address this issue in Ohio .

AMCNO members are invited to participate in the Availity Customer Connection to take place in Cleveland on April 28th. For more information see below.

2010 Availity Customer Connection Cleveland Event

Attention physicians, hospital and office staff, office managers, and billing staff, please join us at an Availity conference in Cleveland on April 28th at the Renaissance Cleveland Hotel, 24 Public Square , Cleveland , Ohio 44113 . Each location has the capacity to seat 250-300 attendees. Because seating is limited, please register as soon as possible by going to this link http://www.rsvpbook.com/event.php?439406

Each person is required to register individually. Registration will be closed when seating capacity is reached.

For more information on the multi-payer project vendor Availity, go to

http://www.availity.com/  For a detailed backgrounder on this initiative go to http://www.americanhealthsolution.org/assets/Uploads/Blog/Backgrounder-Ohio.pdf

For additional information on the AMCNO support of this initiative contact Elayne R. Biddlestone at the AMCNO offices at ebiddlestone@amcnoma.org or (216) 520-1000.