Can billing offices save time and money in insurance payments through EHRs?

Last month, five national health insurance plans along with the two largest plan industry groups announced that they will be launching a groundbreaking initiative in New Jersey to cut insurance paperwork for physicians' offices.

If it's successful, the initiative will be the first experiment in EHR adoption to cut down on chasing insurance money, what providers say is the biggest time and money drain on their practices.

According to a New York Times article about the initiative, the five plans - Aetna, AmeriHealth New Jersey, Cigna, Horizon Blue Cross Blue Shield of New Jersey, and United Healthcare represent about 95 percent of privately insured patients in New Jersey.

The plans are collaborating with two industry groups, America's Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association (BCBSA), and are using a multi-payer web portal developed by NaviNet, Insurer Connect.

According to AHIP, five physician groups are also collaborating on the project, namely, the Medical Society of New Jersey; New Jersey Academy of Family Physicians; New Jersey Association of Osteopathic Physicians and Surgeons; New Jersey Medical Group Management Association; and Partners in Care, Corp.

The health plans will provide the portal service to 50,000 providers at zero cost, and NaviNet says it will offer them one place where they can, in real-time: check eligibility and benefit information; submit and inquire about claims; and check referral and authorization submissions.

A probable twist in the system is that the individual plans still have to feed the site information, and not all the plans provide the same level of electronic health data, according to the Times. This means that doctors will still be obtaining different levels of individual EHR info from different subsections of the NaviNet portal.

However, provider groups are hopeful. Leaders at the New Jersey Academy of Family Physicians, one of the collaborating physician groups, continue to state their concern that administrative responsibility on physicians grow every year, but they affirm that this initiative is at least a step in the right direction.

A study put out late in 2009 by the Center for Studying Health System Change and referenced on the NJAFP's web site found a gap between policymakers' expectations of and practitioners' experience with EHR. According to the study, what's really required to make EHR work is to reform payment policies to address coordination of care, even within a single providers' office, but certainly among practices.

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