Health Insurance Web Portal Announced for Ohio

At an announcement at the Ohio Statehouse today, health plans and physician groups launched a landmark initiative to make delivering and getting health care easier for patients and their physicians by reducing the time, effort, and expense for the “paperwork” required for each patient office visit. The initiative, which will simplify information flow between health plans and doctors’ offices, and later between health plans and hospitals, is comparable to what ATMs did for banks and consumers.

“Working collaboratively to find ways to simplify administrative processes for providers and patients is a priority for the member companies of the Ohio Association of Health Plans” said Kelly McGivern, President and CEO of the Ohio Association of Health Plans. ”This innovative project will help streamline and accelerate insurance eligibility and payment processes, saving time for both providers and patients. We are pleased that Ohio was chosen for this pilot and hope the results can advance programs in other states.”

Beginning in Ohio later this month, America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association (BCBSA) will sponsor regional and statewide initiatives to assess how best to offer physicians access to multiple insurers through the same channel of information exchange (e.g., a web portal) in a given region of the country for the purpose of conducting key office tasks. Savings are estimated in the hundreds of billions of dollars as the entire health care system achieves efficiencies through similar moves to automation and consistent business practices.

This landmark initiative addresses the need for one-stop service in electronic transactions that physicians have advocated for strongly, and is a requirement to achieve the level of savings that is ultimately possibly. It replaces a cumbersome system in which physician office staff spend considerable time at considerable expense accessing multiple channels to get the information needed to complete basic requirements for confirming eligibility, billing, and referrals. The ultimate goal is to develop regional services that span the entire country.

The Ohio initiative offers opportunities to simplify the work associated with patient visits and achieving savings, including providing physicians with information in “real-time” that:

• Allows office staff to quickly determine key eligibility and benefit information (e.g., co-pays, co-insurance, and deductibles, and differences in coverage for services provided in- versus out-of-network), minimizing the number of staff needed for such purposes;
• Gives physicians access to current and accurate information on the status of claims submitted by physician offices for payment by insurers. This will minimize the need for follow up steps by office staff or submission of duplicate claims that delay rather than expedite payment in most systems;
• Tests real-time referrals and timely pre-authorization of services; and
• Provides for the online submission of a healthcare claims.