Humana and BCBSF Spur Effort to Provide More Integrated Real-Time Claims Adjudication Channels for Physician Offices.Humana, Availity, Blue Cross and Blue Shield of Florida Blue Cross and Blue Shield of Florida is Florida's largest health insurance provider and plan administrator. The company is a member of Blue Cross and Blue Shield Association. The nonprofit, Jacksonville-based Blue Cross and its subsidiaries serve more than 8. and athenahealth Join Efforts LOUISVILLE, Ky. -- Humana Inc. (NYSE NYSE See: New York Stock Exchange : HUM) today announced that the company, along with Availity LLC (Logical Link Control) See "LANs" under data link protocol. LLC - Logical Link Control , its primary electronic data interchange See EDI. (application, communications) electronic data interchange - (EDI) The exchange of standardised document forms between computer systems for business use. EDI is part of electronic commerce. and real-time gateway, will be working with other payers, claims clearinghouses and practice management groups to expand integrated real-time claim adjudication The legal process of resolving a dispute. The formal giving or pronouncing of a judgment or decree in a court proceeding; also the judgment or decision given. The entry of a decree by a court in respect to the parties in a case. channels. The joint effort is part of an on-going initiative to simplify administrative tasks and help physicians obtain payment for services from patients more quickly. This phase of the expansion will include physician practices that use athenahealth, with its revenue cycle management solution, and Blue Cross and Blue Shield of Florida, Humana's partner in Availity. The move is another example of the commitment Humana, Blue Cross and Blue Shield of Florida and Availity have to an integrated, simplified experience for doctors' offices. The expansion was announced Sunday at the Medical Group Management Association's (MGMA MGMA Medical Group Management Association MGMA Metro Global Media, Inc. (stock symbol) MGMA Metal Gutter Manufacturers Association (UK) MGMA Michigan Gospel Music Association ) national convention in Las Vegas Las Vegas (läs vā`gəs), city (1990 pop. 258,295), seat of Clark co., S Nev.; inc. 1911. It is the largest city in Nevada and the center of one of the fastest-growing urban areas in the United States. . Humana launched an integrated real-time claims adjudication (RTCA RTCA Radio Technical Commission for Aeronautics RTCA Rivers Trails and Conservation Assistance (National Park Service) RTCA Rio Tinto Coal Australia RTCA Requirements and Technical Concepts for Aviation ) initiative earlier this year with the goal of making it easier for provider offices to get real-time information, simplifying the collection process, and allowing physicians to more accurately collect patient-owed portions of claims at the time of the office visit. It works especially well for doctors seeing patients with coinsurance-based plans, specifically high-deductible health plans. RTCA enables physicians to submit a claim at the time of service, receive a fully adjudicated claim response from the payer and collect the appropriate payment before the patient leaves the office. "We're pleased to collaborate with athenahealth and Blue Cross and Blue Shield of Florida on this real-time claims adjudication initiative," said Bruce Perkins, Humana's senior vice president of national contracting. "Humana's new relationship with athenahealth and expanded role with Blue Cross and Blue Shield of Florida helps build a multi-payer solution with the power to reduce redundancy and complexity in the health care system. This program also reinforces Humana and Blue Cross and Blue Shield Blue Shield A US not-for-profit health care insurer that is a reimbursement intermediary for physicians. Cf Blue Cross. of Florida's dedication to being industry leaders in health care technology collaboration." "In our commitment to making it easier for providers to do business with health plans, Blue Cross and Blue Shield of Florida has been providing real-time claims adjudication as a value-added service A value-added service (VAS) is a telecommunications industry term for non-core services or, in short, all services beyond standard voice calls and fax transmissions. to physicians," said Elana Schrader, M.D., vice president provider services for Blue Cross and Blue Shield of Florida. "We are committed to a multi-payer solution and are pleased to see the participation of additional payers in order to expand the prevalence of this capability in the market." The expansion increases the number of health care vendors who are already participating in this RTCA initiative, including ZirMed, which is the connection for most of Humana's current production sites. "athenahealth's goal is to empower our provider clients with information that helps them collect what they are owed more quickly and efficiently. This has become increasingly important with growing patient responsibility due to the consumer directed healthcare movement," said Kim LaFontana, vice president of strategic alliances at athenahealth. "We are thrilled to partner with a leader like Humana for this real-time adjudication pilot, as this is one of several areas we are aggressively pursuing to get providers relevant information at the time of service, which dramatically improves their bottom line." As high-deductible health plans continue to increase in number over the next few years, doctors will grow increasingly frustrated frus·trate tr.v. frus·trat·ed, frus·trat·ing, frus·trates 1. a. To prevent from accomplishing a purpose or fulfilling a desire; thwart: if they have to perform RTCA differently for each payer. Humana believes that partnering with other payers through this multi-payer model is the most efficient and physician-friendly solution in the market today. About Humana Humana Inc., headquartered in Louisville, Kentucky “Louisville” redirects here. For other uses, see Louisville (disambiguation). , is one of the nation's largest publicly traded health benefits companies, with more than 11 million medical members. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals. Over its 45-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio. More information regarding Humana is available to investors via the Investor Relations Investor relations The process by which the corporation communicates with its investors. page of the company's web site at http://www.humana.com, including copies of: * Annual report to stockholders; * Securities and Exchange Commission filings; * Most recent investor conference presentation; * Quarterly earnings news releases; * Replays of most recent earnings release conference call; * Calendar of events (includes upcoming earnings conference call dates, times, and access number, as well as planned interaction with research analysts and institutional investors); * Corporate Governance Corporate Governance The relationship between all the stakeholders in a company. This includes the shareholders, directors, and management of a company, as defined by the corporate charter, bylaws, formal policy, and rule of law. Information. About Blue Cross and Blue Shield of Florida Blue Cross and Blue Shield of Florida is a leader in Florida's health industry and is committed to working for an excellent, efficient health system. BCBSF BCBSF Blue Cross/Blue Shield of Florida is a leader in providing innovative capabilities including CareCalc, the industry's first capability that helps providers and members understand the financial responsibility for health care services prior to or at the time of service. BCBSF and its subsidiaries serve more than 8.6 million people. Since 1944, the company has been dedicated to meeting the diverse needs of all those it serves by offering an array of choices. BCBSF is a not-for-profit, policyholder-owned, tax-paying mutual company. Headquartered in Jacksonville, Fla., BCBSF is an independent licensee of the Blue Cross and Blue Shield Association
About athenahealth, Inc. athenahealth provides the only physician revenue and clinical cycle management offering that integrates web-based practice management and EMR (ElectroMagnetic Radiation) The emanation of energy from everything in the universe. Although the EMR from electrical and electronic devices is typically measured for practical, every-day situations, every object, including humans, emanates energy. software, continually updated payer knowledge, and back office processing specialists into a single service. The results are faster payment at lower cost, increased patient care, higher revenue retention and less hassle for the more than 8,000 providers using athenahealth nationwide. The company collects close to $2 billion on behalf of its clients annually. athenahealth is dedicated to helping providers make optimum use of their time, ultimately improving the quality of service delivered and the financial reward for it. For more information about athenahealth, visit our Web site at www.athenahealth.com or call 1-888-652-8200. |
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