Portal for E-Claims

Claims
Triad Healthcare (Plainville, Conn.), an allied specialty healthcare solutions provider, selected MD On-Line (Parsippany, N.J.) to facilitate provider submission of electronic claims for Triad's Aetna (Hartford; $22.5 billion in revenue) members in select areas of New Jersey. As part of the arrangement, MD On-Line has built a Web portal through which chiropractic provider claims submissions will be processed. The portal will allow Triad Healthcare to pay the chiropractic claims transactions for Aetna's New Jersey HMO-policy participants.

Since chiropractic services are specialized, the claims transactions must comply with special regulations under HIPAA, according to Agostino Villani, CEO and president of Triad Healthcare. By outsourcing provider claims processing and provider compensation to MD-Online and Triad Healthcare, Aetna can reduce the time it takes to pay for provider services down to three days, he asserts. "This partnership will help Aetna speed claims processing, help maintain regulatory compliance to HIPAA and improve its relationship with healthcare providers," says Villani. --M.W.