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Blue Cross and Blue Shield Initiatives Recognized for Increasing Patient Safety and Efficiency
Date:9/10/2007

e, Web based application that places all of a member's high-level information in one secure location. The Toolbar was originally launched at WellPoint companies in California, Georgia, Missouri and Wisconsin. The success of the initial release of the MAS Toolbar has prompted WellPoint to replicate the online program in nine additional states.

Online Pre-Certifications

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
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SOURCE Blue Cross Blue Shield Association
Copyright©2007 PR Newswire.
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