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June 21, 2006
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eHealth Insider June 2006; Volume 7, Number 6
Medica finds educating providers is key to clean claims...Palo Alto Medical bolsters patient health with EMRs...Chart: Medica claims processing performance metrics...BCBS-TN uses predictive modeling to lower costs...Top 8 claims issues facing payers and providers...and more...
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EDUCATING PROVIDERS IS KEY TO SENDING CLEAN, TIMELY CLAIMS
Creating a provider college, self-service models and quarterly meetings with top network providers, among other measures, helped Medica (Minneapolis) to consistently achieve claims turnaround times of 8.5 days with an accuracy rate of 98.5%.
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PAMF HAS 60,000 PATIENTS WITH EMRs
Palo Alto Medical Foundation (Palo Alto, CA) has 60,000 patients—representing about a third of its total patient population—signed up for the group’s electronic medical record service created in 2002, according to Paul Tang, M.D., chief medical information officer.
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BCBS-TN USES PREDICTIVE MODELING TO LOWER COSTS
By appropriately identifying members who would benefit from catastrophic case management, Blue Cross Blue Shield of Tennessee (Chattanooga, TN) has decreased its catastrophic case load to 10,000 in 2003 from 17,000 in 2002, a company official said.
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