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Securing Easier Access

As part of an ongoing effort to enhance service through automation, BlueCross BlueShield of South Carolina (Columbia; combined revenues of more than $3 billion) has launched My Remit Manager, a secure browser-based program that allows providers to look up patients' claims and outstanding balances while maintaining compliance with Health Insurance Portability & Accountability Act (HIPAA) regulations, which state that insurers must protect the privacy of health-related data. "What we are doing with the Web is to make the claims process more efficient while still remaining compliant. We have built technology based on regulation and providers' needs," says Jim Daley, HIPAA program director, BCBSSC.

Released in October, My Remit Manager also allows providers to build historical member-specific remittances that they can sort, view and print, and it highlights any claims that have errors or were denied. The function is a much-requested security addition to BlueCross' real-time electronic claims submission and processing Web site, which was introduced to fulfill providers' requests in 1999 and has seen a steady increase in use, according to the company.

"Ninety percent of our claims were received electronically [in October], and 93 percent of provider inquiries are closed without human intervention," says David Boucher, AVP for healthcare services at the insurer. --M.W.

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