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Rollout of New Health Care Provider Tools Creates Meaningful Transactions to Streamline Medical Claims
Date:6/15/2009

New tools help Highmark members navigate health insurance

PITTSBURGH, June 15 /PRNewswire/ -- Collaboration within the health care system and administrative efficiencies are fundamental elements to any number of today's health care reform proposals in Washington, DC. New tools from Highmark to conduct real-time claims processing and real-time member liability estimation are driving collaboration and streamlining medical claims processing right in health care provider offices.

Real-time claims processing and real-time member liability estimation assist physicians and other providers to receive payment for their services and relieves the guesswork for members about the cost of their medical treatment. With real-time claims processing and real-time member liability estimation, Highmark members know their actual out-of-pocket health care costs based on their benefits when they schedule and/or receive health care services. Physicians can discuss the costs with members and make payment arrangements or collect payment at the time care is delivered.

Through real-time tools, Highmark's network providers -- physicians, hospitals, imaging centers, ambulatory surgical centers and other types of providers -- are now able to determine a member's financial obligation before a service is rendered and to collect payment when the member receives care. Providers submitting real-time claims may also receive the portion of the payment that comes from Highmark in a shorter timeframe than in the past.

About 250 providers across Highmark's 49-county service area in Western and Central Pennsylvania began using real-time tools during the initial roll-out period, which began in November 2008. During January and February 2009, these providers submitted nearly 10,000 transactions that identified approximately $395,000 worth of payments due from members.

These real-time capabilities are especially help
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SOURCE Highmark Inc.
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