Reimbursement

ICD-10 implementation and compliance issues associated with the HITECH Act are on the minds of medical billing companies, according to a speaker at the 2009 Fall National Conference of the Healthcare Billing and Management Association.

Three out of every four insurance claims from healthcare providers are being submitted electronically to AmeriHealth New Jersey – an increase of 50 percent over the past three years, according to the New Jersey-based insurer.

Shared Health is slated to begin rolling out in December a solution that would give Mississippi Medicaid providers a Web-based electronic health record system and e-prescribing capability.

America's Health Insurance Plans has contracted with MedAssurant, Inc., a Bowie, Md.-based data solutions provider, to provide data analytics services.

One Beacon Professional Partners, a member of the OneBeacon Insurance Group, is collaborating with Medversant Technologies to provide clients with an electronic credentialing verification and management system.

 Health insurers' focus on administrative cost reduction has been intensified by the economic recession and Washington's healthcare reform agenda. More focused spending for healthcare IT solutions that demonstrate the ability to take cost out has spiked as a result – at least for NaviNet.

Employer groups and payers are increasingly using online tools to control healthcare costs and improve their employee and member health status. "Employers are placing a significant burden on their health plan partners to provide the necessary tools and direction so employers can evaluate specific relevant trends and take action where needed," said Kevin O'Mara, vice president of Health Data Management Solutions (HDMS).

Care Health Plan is planning to release a second round of healthcare information technology grants in 2010 to position local community clinics to take advantage of HITECH Act funds. The largest U.S. public health plan's grants support its mission to aid safety-net providers, provide funding for their long-term needs and address healthcare IT disparities, said Roland Palencia, director of community benefit programs.

The Centers for Medicare and Medicaid Services (CMS) posted on the RAC Web sites the first new issues of completed reviews in early August. Providers will use the reviews and the Office of Inspector General's audit roadmap to create or fine-tune internal processes for the Recovery Audit Contractors (RAC). CMS has not issued any guidance to providers in terms of using IT to help with compliance and auditing nor does it recommend software, said Connie Leonard, director of Recovery Audit Operations.

MN Community Measurement announced Wednesday it has published new information online about how much medical groups in Minnesota are paid to provide more than 100 common healthcare services.