Healthcare IT News - March 2008 - (Page 29)

www.HealthcareITNews.com pAYERS March 2008 ■ Healthcare IT News 29 Insurers reimburse IADMD members for online visits By Molly MErrIll, Associate Editor - Aetna and Cigna have agreed to reimburse dentist and physician members of the International Association of Dental and Medical Disciplines who provide online visits to their patients. Founded by John J. Ryan, DMD, the International Association of Dental and Medical Disciplines, or IADMD, is a professional assoSALEM, NH ciation of dentists and physicians dedicated to patient advocacy and promoting their doctor-led version of universal healthcare. IADMD says this is a major milestone for its members who already have access to resources such as free doctor Web site and free hosting, online bill pay, prescription refill service, and email services. “We are not an IT services com- pany; we are a chartered profes- tive and we are operational with sional society of doctors of all private HIPAA secure servers using 128/256 bit disciplines We are doctors working encryption that gives our for doctors with insight to that allows members free access to our the entire claims process ” for private patient porIT depart– John J. Ryan, DMD tals for virment as a tual visits, and online bill pay, so membership benefit. We are doctors working for doc- effectively the virtual visit and tors with insight to the entire claims co-pay can be one-in-done,” said process from the doctors’ perspec- Ryan, a dentist in East Hampstead, N.H. and a Dental Examiner for the North East Regional Board of Dental Examiners. “These sessions are custom for each doctor member in accordance to their needs. We are working privately with each doctor member and their insurers to ensure reimbursement as agreed,” Ryan said. ■ More at HealthcareITNews.com e Connect: oNlINe 0308 ● lookUP Continued from page 1 for Enclarity. A substantial percentage of information from list suppliers is out of date and inaccurate, she said. “The ability to find trusted information in one place will make life dramatically better for payers,” she said. Using analytics and a master provider referential database, Enclarity draws from multiple sources to build a complete view of providers. “This type of information is critical to running a business more efficiently,” she said. “Provider information is key to so many areas – operations, customer service, contracting.” The ability to load provider information quickly can also result in faster, more accurate payment of claims, thereby improving both member and provider satisfaction. With consumers going out of network or out of service area for healthcare needs, payers must now retrieve data on nonparticipating providers. One health plan, which is seeing an increase in out-of-state claims, has reduced its research time for verifying provider information on these claims by 66 percent. The health plan’s research time on these claims on average dropped from 32 minutes per provider to 11 minutes per provider. “There is a lot of potential in this tool because there is a lot of unmet need,” said Matthew Guldin, healthcare and life sciences information technologies analyst at Frost & Sullivan. An automated system of updating provider information would decrease claim rejection rate because one of the top reasons for rejection is incorrect provider information, he said. Returned mail and the re-issuance of checks due to wrong provider information would also be eliminated. An automated system would also improve customer service and provide transparency for consumers wanting complete information on providers, he said. “I imagine there is a lot of receptiveness to this tool,” Guldin said. He cautioned that receptivity would also be tied to how Enclarity structures its fees. ■ More at HealthcareITNews.com e Connect: looKuP 0308 ● e ● Connect: elSevIer 0308 http://www.HealthcareITNews.com http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8884 http://www.clinicaldecisionsupport.com http://www.clinicaldecisionsupport.com http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8853

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Healthcare IT News - March 2008 Contents No. 1 E-prescribing ‘Quite Bright’ Bill Frist on IT Google Connection Poised for P4P ‘Smashing Success’ Tough On Fraud It's Analytics Getting Rid of the Pain Stuck In Neutral

Healthcare IT News - March 2008

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