Insurer UnitedHealthcare and athenahealth, which provides Web-based business services for physician practices, are working together to expand the two companies' real-time claim adjudication capabilities.
This effort enables physician offices nationwide using athenahealth's on-demand practice management service to submit UnitedHealthcare claims and receive a fully adjudicated response in seconds.
Watertown, Mass.-based athenahealth submits more than 1.5 million claims a year to UnitedHealthcare and works with medical providers in 33 states.
UnitedHealthcare first launched real time claims processing in January 2007, using its dedicated physician Web site, Physician office staff submitting claims through the site can receive a fully adjudicated claim in seconds, reducing administrative burden and allowing patients to pay for services before leaving the doctor's office, according to athenahealth executives.
"In order to streamline the system for physicians and consumers, UnitedHealthcare is advancing technologies that operate on a single platform and can be used by anyone within the healthcare system, said UnitedHealthcare CEO Ken Burdick. "By collaborating with athenahealth and expanding the availability of real time adjudication, we are helping to reduce costs for consumers and physicians and bringing the healthcare industry a step closer to a more retail-like environment."
Connecting real-time adjudication into athenahealth's national physician platform expands UnitedHealthcare's real-time capability to the critical practice management workflow and desktop space, which is an important advancement since most physician offices use third-party solutions or have to dual-submit claims for traditional real-time adjudication platforms, according to athenahealth.
"UnitedHealthcare's continued expansion of real-time claim adjudication shows its commitment to simplifying physicians' and consumers' healthcare finances," said Jonathan Bush, chairman and CEO of athenahealth. "By leveraging a national network like athenahealth, thousands of medical providers and their staff will now be able to collect payment from their patients faster and more accurately."