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March 2006
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eHealth Insider March 2006; Volume 7, Number 3
How BCBS-MA boosted its EDI and first pass auto adjudication rates...Technology manages claims in real-time to meet consumer-driven market...A closer look at the repricing technology...Lumenos launches cell phone service to look up low cost prescription alternatives...and more...
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TECHNOLOGY MANAGES CLAIMS IN REAL-TIME TO MEET CONSUMER-DRIVEN MARKET
Ask any doctor or hospital administrator what they think about an HSA and they will grimace about the individual claim management aspect and the threat of increased accounts receivables. The fear of an individual having a $5000 deductible is more than providers are comfortable managing.
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A CLOSER LOOK AT THE REPRICING TECHNOLOGY
Here’s how Competitive Health’s repricing technology works
• Explaining the member’s program—At the beginning of the call, a customized “Dear Provider” letter is faxed to the provider’s office. This can offer relief to the time-strapped physician office that also has high turnover and training problems. The letter can also identify secondary PPO networks or negotiate a discount at the point of service for out of network providers.
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LUMENOS LAUNCHES CELL PHONE SERVICE
Lumenos (Alexandria, VA), a division of WellPoint, last month launched a cell phone service that lets consumers type drug names into their cell phone Web browsers to access lists of lower cost alternatives.
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