STAMFORD, CT – While a large majority of providers are using technology to verify patients’ eligibility, many are not aware of initiatives under way to reduce common administrative hassles in healthcare.
A survey of 800 healthcare providers this month by IVANS Inc. indicated that 75 percent of them use some type of electronic eligibility verification technology.
Of those using such technology, almost 64 percent rate the level of their eligibility verification as good or excellent, said Clare DeNicola, president and CEO of the Stamford, Conn.-based vendor that provides EDI services and solutions.
The survey, kept short and sweet to maximize quick provider response, did not stratify results by practice size. Also, DeNicola said, it didn’t attempt to tease out whether providers are using sophisticated electronic transaction technology or more low-tech approaches, such as telephone-based interactive voice response.
DeNicola said she is surprised by the high use of technology to verify eligibility – but there is a need for further adoption of technology.
“We believe a lot of providers are using interactive voice response systems, but our premise is that providers need to do more,” she said. “As the healthcare field becomes more consumer-driven, high-tech solutions like real-time eligibility verification technology grow more important.”
Providers will face more risks as consumers take on higher deductibles, and they’ll face pressure to confirm eligibility for coverage and other information so they can collect patient payments when healthcare services are delivered.
The survey found that most providers are unaware of the Committee on Operating Rules for Information Exchange, an initiative launched by the Council for Affordable Quality Healthcare. The CORE project seeks to reduce the time and resources providers spend on administrative functions. Estimates suggest that administrative functions consume as much as a third of each healthcare dollar.
CORE is working to reduce variability in the information required by payers for handling healthcare transactions.
Once told about CORE’s purpose, about half of the providers responding to the IVANS study said they believe it could streamline their administration, and 25 percent said they believe it will decrease costs.
“What’s striking to me is that there’s wide-openness among providers to be able to do things more efficiently and get costs out of the system,” DeNicola said. “The industry is right on the cusp of being able to make this happen. We can reduce costs of the healthcare system by adopting necessary standards.”