INTERACTIVE ELECTRONIC HEALTHCARE TRANSACTIONS BEGIN FLOWING BETWEEN CALIFORNIA MEDICAL PROVIDERS & NATION'S LARGEST MANAGED HEALTHCARE PLANS
SECAUCUS, N.J., June 11 /PRNewswire/ -- California medical groups and Independent Practice Association (IPAs) can now electronically verify patient eligibility and benefit coverage, out-of-pocket expenses and coverage exceptions for California residents covered under managed care programs offered by PacifiCare Health Systems, Aetna, Cigna, John Hancock, Metropolitan and Travelers via the National Electronic Information Corporation (NEIC) Healthcare Information Network(SM) (HCIN). There is also on-line activity in Texas, Virginia and Ohio where HCIN is currently in this pilot phase. Participating managed healthcare payors are looking forward to implementation in the California marketplace when the HCIN roll-out takes place later this year. "Live transactions are speeding their way between California providers and payors on the nation's first interactive electronic highway -- providing a single, reliable source for rapid and accurate information exchange," explains Kenneth J. O'Donnell, president and CEO of NEIC, the nation's largest healthcare electronic data interchange (EDI) network. "HCIN's interactive capabilities are bringing healthcare communications to a new level of efficiency, eliminating paperwork and telephone calls and thereby reducing administrative costs." According to PacifiCare Health System's president and CEO Alan Hoops, "This all payor/all player network allows medical groups or hospitals to exchange information with multiple managed care companies using only one system." Hoops adds that this new technology enhances PacifiCare's ability to meet the goals of achieving quality, cost- effective care. California medical providers are equally pleased with HCIN's performance.
Michael Linn, executive vice president and chief operating officer of Healthcare Partners, a multi-specialty medical group in the San Gabriel Valley and greater Los Angeles that participates says, "HCIN gives us immediate access to a patient's health plan coverage and eligibility, saving us time and money, and helping us to provide better patient service by delivering appropriate treatment in a timely fashion."
O'Donnell stresses that NEIC is actively working with the American National Standards Institute (ANSI) in the development of interactive versions of the ANSI standards for eligibility requests (Standard 270) and responses (Standard 271). These transactions will support payor and provider access to current information regarding patient eligibility for benefit coverage. "Industrywide implementation of ANSI standards is critical," says O'Donnell. He points out that NEIC has always supported the adoption of ANSI standards as well as recommendations from the Workgroup on Electronic Data Interchange (WEDI) to the Clinton Healthcare Reform Task Force. O'Donnell forecasts that with standard formats and full implementation of HCIN, the country will benefit from a more streamlined, hassle-free healthcare system. "With the power of EDI and the success of HCIN in California and other states, the outlook is very positive," concludes O'Donnell. More than 130,000 providers currently submit claims and other associated transactions through NEIC and its network of 500 vendors to member payors including managed healthcare entities. Taken together, these payors provide healthcare coverage to over 110 million Americans. -0- 6/11/93 /CONTACT: Geoff Cook of CPR Marketing Communications, 201-342-9111, for National Electronic Information Corporation/
CO: National Electronic Information Corporation ST: New Jersey, California IN: SU:
LD-TS -- NY064 -- 1273 06/11/93 17:55 EST
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|Date:||Jun 11, 1993|
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