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Health Claims Progress on Web

Internet-based claims processing services enjoy limited success.

Health insurers have enjoyed success using the Web to deliver a variety of improved customer service functions, and some carriers are moving to explore uses of the Internet in the more daunting territory of claims processing.

In the past few weeks, for example, Blue Cross Blue Shield of South Carolina (BCBSSC, Columbia, more than $1 billion in assets) now allows physicians to process standard HCFA 1500 forms through its My Insurance Manager portal on the Web site (see related story, page 57), and Oxford Health Plans (Trumbull, CT, $1.54 billion in assets) launched Chester, NJ-based M.D.On-Line's all-payer ASP solution, allowing care providers to submit claim print files over the Web.

Chris Thompson, executive vice president, Recognition Research, Inc. (RRI, Blacksburg, VA), says of BCBSSC's solution, "It's another avenue for a payer to connect with a provider, and that's a good thing," he says. Speeded payments also provide a needed incentive to providers, who have to enter claims twice—once onto the carrier's Web site and once into the provider's practice management system, Thompson adds.

Oxford's M.D.On-Line solution—which Thompson notes doesn't amount to direct submission of claims into a browser—has been designed to avoid that obstacle, as it works with any practice management system that can create a print file of a standard claim form. It extracts claims files from practice management systems and transmitting them in a format acceptable to any carrier the healthcare provider works with, explains Katie Krapes, Oxford's vice president of e-business. The all-payer solution was chosen to drive adoption by physicians, she adds.

Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio

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