eBill Processing Systems Align with Leading Stakeholders to Boost Health Care Provider ANSI ASC X12 837 Bill Submissions and Infrastructure for
Medical EDI Transactions
CONCORD, Calif., March 25 /PRNewswire/ -- Jopari Solutions, Inc., a leading P&C industry bill cycle automation and workers' compensation eBill processor, reports significant progress in integrating national and regional carriers, managed care networks, providers and their medical billing technology suppliers to achieve a compliance solution for the Texas electronic medical billing mandate. Over thirty workers' compensation payers have implemented Jopari's eBill Platform, representing about fifty-percent of the state's projected annual eBill transactions. This influential group of stakeholders is working with Jopari to expedite submission of fully compliant eBills by health care providers across the state.
Texas regulatory compliance entails medical providers having the ability to submit, and payers the ability to receive and process, electronic medical bills and related documentation. Although ANSI ASC X12 837 jurisdictional electronic formats for exchange of medical bill data are specified under Title 28 of the Texas Administrative Code, Jopari is also working with providers and payers to facilitate participation by managing mutually agreed non-prescribed electronic formats. Jopari's Web-based platform delivers an array of tools to providers for eBill and document submission that wrap around existing payer bill review and claim systems, while preserving existing business rules and operational requirements.
Jopari is engaging medical billing technology suppliers in a broad effort to expand eBill submission options for health care providers. The Company views these technology relationships as essential because a statistically significant fraction of the provider market indicates preference for current health claim submission arrangements as opposed to alternate workflows or implementation through clearinghouses.
Stated J.R. "Steve" Stevens, CEO of Jopari Solutions, "Offering an array of connectivity options that allow providers to utilize their existing automation tools more fully, being careful to minimize impact on current billing workflows, will significantly improve eBilling efficiencies and utilization."
In advance of its January 1, 2008 eBill mandate, the Texas Department of Insurance Division of Workers' Compensation (TDI/DWC) anticipated that a variety of practical constraints could affect timely stakeholder implementation. Accordingly, TDI/DWC allowed that certain business entities could qualify for a temporary waiver based on technical or business issues -- in advance of undertaking verifiable steps to complete eBill preparations. Such delayed implementation waivers must document an implementation plan and date-certain time frame to meet electronic billing and reimbursement requirements. Consequently, several large carriers, and a majority of health care providers, continue to use of their current non-electronic billing practices, pending implementation.
"The waiver process has demonstrated a sophisticated understanding by TDI/DWC that this eBill initiative consists of a lot of moving parts," said Stevens. "They recognized and fostered a collaborative approach to achieving compliance that brought together all of the stakeholders."
Added John Roberts, Jopari Senior Vice President: "At first a daunting number of technical and business issues challenged full adoption of eBill rules. We are now seeing, however, that the cooperative approach we and other stakeholders have undertaken to address and solve implementation issues is succeeding. We believe the Strategic eBill Information Network (http://www.sebin.pbwiki.com), for example, is creating a strong foundation both for Texas and extending medical EDI to additional state jurisdictions. The cooperative knowledge base being created will improve workers' compensation overall as the state administered component of the health care delivery system."
Jopari Solutions, Inc. (http://www.jopari.com) supplies Integrated Compliance and Payment Solutions to Workers' Compensation, Auto, and Health Insurance Industry Payers, as well as eBill submission and management tools for medical providers. Jopari services are SAS70 Level 1 & 2 certified, in addition to HIPAA, GLBA and OFAC compliant. Jopari significantly improves the technology Payers use to manage bills and disbursements, and reduces associated expenses. Jopari services enable insurance Payers to comply fully with regulatory requirements, including e-Bill and e-Pay jurisdictional initiatives and HIPAA. Insurance and other industry Payers take advantage of JopariPay(TM) to enhance bill cycle processing, reduce operating expenses, and improve operational metrics.
|SOURCE Jopari Solutions, Inc.|
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