Slashing administrative waste: Pennsylvania medical group uses Web technology to reduce the expense of interacting with health plans
Categories: Medical GroupWith today’s rising healthcare costs, specialists are under the gun to save money wherever possible, while still providing top-notch care. Providers stagger under the weight of administrative loads generated by even small practices, while the demands of patients, affiliated health plans and referring providers grow each day.
By moving paper-, phone- and fax-based processes to the Web, healthcare organizations can help slash the high cost of administrative waste. One important element of successfully managing and streamlining the administrative flow of interacting with health plans is Web-based connectivity.
Health Plans Can Help
Not long ago, Orthopedic and Sports Medicine of Erie (OSM) was a prime example of an overburdened provider. With three physicians and 35,000 patients, the practice was overwhelmed with the paperwork required to correspond with its affiliated health plans. Finally, with no viable solution to help her staff as they struggled to stay on top of the workload, Practice Manager Charlene Kellerman began looking for a way to handle the day-to-day functions required to keep the practice running smoothly.
With 30 percent of OSM’s patients covered by Highmark Inc., Kellerman went directly to the health plan to lobby for a better way to handle administrative transactions. “We asked Highmark to find a way to use the Internet for some of our paperwork and other manual processes,” she said. “The paper chase for referrals alone was unbelievably difficult, and our staff could barely keep up with the workflow. Highmark took our request seriously, and we were one of the health plan’s first providers to begin processing transactions via the Web.” That was in the fall of 2000, and Kellerman and her staff have been enjoying the benefits of Web-based connectivity ever since.
Pain-free Connectivity
Luckily for OSM, choosing the technology was painless. The practice did not have to endure the process of evaluating its needs, debating whether to buy or to build, choosing a technology vendor or integrating the technology into new and existing processes. Highmark had already done that homework and deployed the technology, NaviMedix’s NaviNet platform, offering it to OSM and the rest of its network providers free of charge.