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Physicians in South Carolina can now file health care claims directly through one of the biggest payers’ Internet sites, saving time in payment turnaround and minimizing filing errors.
The physicians who are using this free service are finding that their claims are processed in just a few days. "The average number of days from the day we receive the claim to the day we actually cut the check is 3.4 days," says David Boucher, senior director of managed care services for Blue Cross and Blue Shield of South Carolina, based in Columbia. "That decreases [providers’] outstanding accounts receivable and increases their cash flow significantly."
Physicians can go to SouthCarolinaBlues.com, CompanionHealthcare.com, or HMOBlueSC.com to register a profile in the secure section, My Insurance Manager. Besides submitting claims on-line, they can use My Insurance Manager to submit referrals, check the status of a patient’s claim, check eligibility, view benefit booklets, check authorizations and referral status, see how much patients have paid toward their deductible and out-of-pocket amounts, and confirm whether a patient has any other health insurance. They also can submit a question or comment on-line with secure messaging.
The majority of the nearly 8,000 physicians in Blue Cross’ networks in South Carolina still file claims through other electronic means. Many transmit their claims in batches through their practice management systems and then through a clearinghouse, Boucher says. About half of the physicians have registered to use My Insurance Manager. Only a few hundred have tried to use the claims function, but Blue Cross is encouraged that more are trying every day. "The number of providers who use this is growing on a weekly basis. We are averaging about 30 new providers a week. Our volume of claims is increasing about 13% a week."
Once physicians fill out claim information and submit it in My Insurance Manager, the claims are sent directly to the company’s data processing center. The system does an immediate error check and informs the physicians if information is missing or incorrect. Physicians can check the next day on the Internet site to see if the claim has been processed, saving time traditionally spent on the phone.
One possible deterrent to filing claims over the Internet may be that the information has to be rekeyed into the Web site, Boucher explains. "On the surface, that appears to be a duplication of effort. The physicians who use this, though, see several advantages. When they hit the enter key and the claim is accepted, they get the claim number on-line. That gives them 100% confidence that we have the claim in-house on our mainframe computer. There are no clearinghouses and no buffering."
The system also edits the claim on-line. "[Physicians] don’t have to look at a report later on telling them what they need to fix. They know right away."
So the minute and a half spent rekeying information into the web site is more than made up later, Boucher says. "It saves time at the other end if you don’t have to have staff on the phone checking the claim status."