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Technology: The cure for Empire Blues. (E-Fusion Conference: Health; Technology).


Empire Blue Cross & Blue Shield Blue Shield A US not-for-profit health care insurer that is a reimbursement intermediary for physicians. Cf Blue Cross. , New York's largest health insurer An individual or company who, through a contractual agreement, undertakes to compensate specified losses, liability, or damages incurred by another individual.

An insurer is frequently an insurance company and is also known as an underwriter.
, was slow to respond to the advent of managed care. That cost the company 7 million members, and the reduction in its statutory reserves from the drop in business brought the company to the brink of bankruptcy bankruptcy, in law, settlement of the liabilities of a person or organization wholly or partially unable to meet financial obligations. The purposes are to distribute, through a court-appointed receiver, the bankrupt's assets equitably among creditors and, in most , said President and Chief Financial Officer David Snow David William Snow (born September 30 1924 (1924--) (age 83)) is an English ornithologist.

Snow was born in Windermere.
.

But, the company has reversed its financial situation and now--having gone public Nov. 7 with a $417.3 million stock offering--has developed a strong Web-based system that is helping it grow as it cuts expenses and becomes more efficient. "Our recovery is attributed heavily to technology," Snow said of the company.

Empire Blues is spending $120 million to enhance communications with its customers in several ways, including connecting all its customer service centers electronically so if one is out of service, phone calls from customers are seamlessly rerouted. That investment paid for itself Sept. 11, when the company's two major call center facilities in the World Trade Center were knocked out during the collapse of the twin towers.

"If that had happened two years ago, before we were digitized, we would have lost a significant amount of time, money, records and quite possibly customers because we wouldn't have been able to serve them sufficiently," Snow said.

A system of comprehensive portals that Empire Blues is developing is so strong that it will be adopted by other Blues plans across the country through an initiative known as the Blues Exchange, he said.

The system includes a portal for each of its client groups--employees, brokers, doctors, members and hospitals. For example, a doctor's office can handle 85 different tasks with the Empire Blues online. One of those features is the "Waiting Room," a way for the doctor's office to move the records of all patients who have appointments with the doctor that day to a folder In a graphical user interface (GUI), a simulated file folder that holds data, applications and other folders. Folders were introduced on the Xerox Star, then popularized on the Macintosh and later adapted to Windows and Unix. In Unix and Linux, as well as DOS and Windows 3.  on the desktop. As each patient leaves the examining room, the reason for the visit and diagnosis are entered and the copay co·pay  
n.
A copayment.
 charges calculated.

This feature is finding favor with physicians because companies are asking their employees to pay larger in-network deductibles that aren't always easy to calculate. Also, every Web page on the site is embedded Inserted into. See embedded system.  with a "Click to Talk" function so the doctor's office can easily reach a customer service representative and get answers to questions about the rate of payment.

A case for encouraging business customers to deal with Empire Blues through the Internet Internet

Publicly accessible computer network connecting many smaller networks from around the world. It grew out of a U.S. Defense Department program called ARPANET (Advanced Research Projects Agency Network), established in 1969 with connections between computers at the
 is stronger, Snow said, because businesses deal with the health insurer every day, compared to consumers, who are most likely to contact the company when they are ill.

Still, there is reason to encourage more members to transact An earlier e-commerce system for the Web from Open Market that included order capture and secure order fulfillment using credit cards, ecash and other payment systems. It included customer service and subscription administration capabilities as well as an integrated database for reporting  all dealings with the company online. Empire Blues is now aiming to trim another expense--the $17.6 million it spends in a year to print and mail "Explanation of Benefits" notices and provider directories to members. That cost, which breaks down to $8.36 per member per month, could be virtually eliminated if all members used the Internet to access their account information.
COPYRIGHT 2002 A.M. Best Company, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2002, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Author:Ostermiller, Marilyn
Publication:Best's Review
Geographic Code:1USA
Date:Dec 1, 2002
Words:508
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