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BLUE CROSS AND BLUE SHIELD AWARDED $1.7 MILLION CONTRACT TO PROCESS CLAIMS FOR BLUE CROSS AND BLUE SHIELD OF MAINE

BLUE CROSS AND BLUE SHIELD AWARDED $1.7 MILLION CONTRACT TO PROCESS
 CLAIMS FOR BLUE CROSS AND BLUE SHIELD OF MAINE


Minnesota Carrier Uses Advanced Claims Processing System, Managed Care
 Experience to Administer Multinetwork Health Plan
 ST. PAUL, Minn., July 20 /PRNewswire/ -- Blue Cross and Blue Shield of Minnesota (BCBSM) has been awarded a $1.7 million contract to process health coverage claims for Blue Cross and Blue Shield of Maine. The contract -- the second major service contract awarded to BCBSM in the last week -- covers claims administration processing for 15,000 Maine plan members.
 Last week, BCBSM, in cooperation with a national pharmacy network management firm, won the contract to manage and administer a retail pharmacy program available to more than three million federal employees, retirees and their dependents.
 "These new relationships establish us on a national basis," said Andy Czajkowski, BCBSM president and CEO. "The highly competitive marketplace in Minnesota has required us to adopt new and innovative ways to manage health care costs, quality and administration. We welcome the opportunity to use this experience for the benefit of members who belong to other Blue Cross and Blue Shield plans."
 The nation's 73 Blue Cross and Blue Shield plans are nonprofit, independently operated, community-based health carriers. Plans often work together to create health benefit programs that satisfy the needs of their customers.
 Under the three-year contract, BCBSM will use its advanced claims processing system to administer Maine's new multinetwork health coverage product. Known as a point-of-service plan, the product blends the cost control mechanisms of an HMO with the flexibility and freedom of choice available in open-access health coverage designs.
 Under such a product, enrollees receive most of their health care services from a designated clinic in the plan's primary care network. However, they also have the freedom to seek care outside the primary network -- either from a larger network of participating health care providers or from providers who do not participate with the Blue Cross and Blue Shield plan. Care received from providers in these networks typically is paid at reduced benefit levels.
 In 1986, BCBSM was the first health carrier in Minnesota, and one of the first in the nation, to make a point-of-service product available to group purchasers of health coverage programs.
 "This type of product sounds fairly simple, and it has been enormously effective in managing health care cost and quality," said William Jenison, BCBSM senior vice president and chief operations officer. "But effectively administering such a product requires special systems and expertise. We are the only carrier in the country that has the systems in place to accommodate it."
 The contract calls for service to begin Jan. 1, 1993. It is estimated that nearly 130,000 health coverage claims will be processed each year.
 Serving more than 1.7 million Minnesotans, BCBSM is the state's oldest and largest health coverage carrier. The company is recognized for its innovations in the areas of managed care, product development and claims administration.
 -0- 7/20/92
 /CONTACT: Mark Heymans of BCBSM, 612-456-8786 or 800-382-2000, ext. 8786/ CO: Blue Cross and Blue Shield of Minnesota; Blue Cross and Blue Shield
 of Maine ST: Minnesota; Maine IN: INS SU:


AL -- MN009 -- 0783 07/20/92 13:22 EDT
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Publication:PR Newswire
Date:Jul 20, 1992
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