AIS’s Health Business Daily describes a New Jersey pilot program with major insurers that aims to cut provider paperwork and standardize processes. The goal is to reduce the costs associated with determining patient eligibility and checking claim status
A typical primary care physician spends about $68,000 a year on administrative tasks such as determining patient eligibility and checking claim status. The goal of a 12-month pilot project — announced Feb. 10 — is to show how that problem might be fixed.
The pilot program will work with all the major insurance plans.
New Jersey’s five largest health plans and five physician groups will participate in the initiative, which aims to dramatically reduce administrative costs by allowing hospitals and physicians to communicate with health plans and address administrative tasks through a single Web portal.
“What we’re producing is a one-stop shop, through which physicians and their offices can contact all of the health plans they deal with” through a single Web portal. The participating health plans are Aetna Inc., Independence Blue Cross subsidiary AmeriHealth New Jersey, CIGNA Corp., Horizon Blue Cross Blue Shield and UnitedHealthcare, Inc.
Providers access access insurance information through the NaviNet web portal.
The portal is maintained by NaviNet, a health care information technology company. Several health plans that operate in New Jersey already use NaviNet. Horizon, the state’s largest health plan operator with 3.6 million members, expects to close its independent portal and move to NaviNet in March or April. During the conference call, Christy Bell, Horizon’s senior vice president of health care management, said the pilot is an opportunity for health plans and providers to move closer to standardizing administrative processes.
Aetna has been using NaviNet’s portal for several years. More than 40% of the health plan’s network providers have access, said Aetna President Mark Bertolini. Along with helping to streamline administrative processes, he said the portal also can be used to improve health outcomes.
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