AMCNO Supports Multi-Payer Web Portal Initiative for Physician Claims |
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The Academy of Medicine of Cleveland and Northern Ohio (AMCNO) is pleased to announce our full support of the plan to launch a multi-payer portal project in Ohio. This landmark initiative will 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. Beginning in Ohio in early November 2009, health insurers will launch 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 will be 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 portal will be implemented in a pilot phase beginning November 2009 and will continue for one year. 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. The initiative is a collaboration of the America’s Health
Insurance Plans (AHIP) and the Blue Cross Blue Shield Association (BCBSA).
The effort will be conducted on a statewide basis because this allows for
the participation of physicians and possibly government programs in given
geographic areas and overlapping service areas for multiple insurers.
Insurers are partnering with local physician organization, like the AMCNO,
throughout the year-long programs 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. In addition, the AMCNO
recently participated in statewide work groups advocating for this type of
initiative on a statewide level. AMCNO will be providing additional
information on this initiative to our members as it becomes available. http://www.availity.com/
For a detailed backgrounder on this initiative go to
http://www.americanhealthsolution.org/assets/Uploads/Blog/Backgrounder-Ohio.pdf
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