For some healthcare services, a pre-certification from the insurer to the provider is required. The MyInsuranceManager Web Precert Program (Web Precert) is BlueCross BlueShield of South Carolina's (BCBSSC) innovative program that streamlines the pre-certification process making it more efficient and less costly. By updating their pre-certification process from fax and telephone to an online process, providers are able to receive real-time resolution to some pre-certification requests. Currently, over 46 percent of all pre-certification requests and inquiries are handled online, greatly reducing the use of long-distance telephone calls. BCBSSC has achieved cost savings thanks to Web Precert. If current trends continue, cumulative costs savings due to Web Precert would total $1.4 million by the end of 2007.
Improving Claim Processing
At Blue Cross and Blue Shield of Illinois (BCBSIL), claims processing is a joint responsibility between the insurer and the Medical Groups/Independent Practice Associations (MG/IPA). By forming the Medical Group Advisory Committee, BCBSIL staff was able to improve administrative issues that either slowed or created mistakes in claims processing. Through this collaborative effort of adopting a more efficient process, past due claims sent to MG/IPAs for review dropped from more than 8,400 to only 816 in the same period the following year.
On September 14, 2007, BCBSA is holding a forum at the National Press
Club in Washington, D.C., to promote how insurers and providers are working
together to improve healthcare quality and patient safety. Rep
|SOURCE Blue Cross Blue Shield Association|
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