Pressure Mounts for Paperless Auto Medical Claims Processing

June 24, 2008

Auto medical claims are on the brink of major change.

Beginning July 15, 2009, all health care transactions processed in the state of Minnesota must be 100 percent paperless. Group purchasers -— for the first time including auto insurance carriers — will be required to process medical bills, payments and remittance advice using a standard electronic format.

The landmark Minnesota legislation, entitled Uniform Electronic Transactions and Implementation Guide Standards, was signed into law in May 2007.

Minnesota is not alone in putting pressure on the industry to become more automated. Texas has electronic billing requirements for workers’ compensation payments while California is developing electronic transaction regulations.

According to claims industry experts, the deadline in Minnesota is firm and there is not a lot of of time for the insurance claims industry to make the transition to paperless.

More than 100 auto insurance executives and managers attending Mitchell Medical’s recent 2008 Industry Conference in Monterey, California, were recently advised of the potential impact of the paperless movement by a panel of Medical Bill Electronic Data Interchange (EDI) experts participating in Minnesota’s process.

“There is no chance Minnesota will delay or derail the effective date for exchanging health care administrative transactions using a standard electronic format,” warned Debbie Meisner, vice president for compliance and payer services, Emdeon Business Services. “The train is leaving the station. Minnesota’s Department of Health responsible for administering this program will not allow waivers or deferred implementations. Payers need solutions quickly.”

Shelagh Kalland, director of provider relations for Blue Cross Blue Shield of Minnesota, said her firm worked four years to get electronic transactions fully operational. “These are complex systems. Starting from scratch is difficult if a payer hasn’t already integrated the ability to exchange electronic health care transactions into its claims workflow, or established connectivity with its provider base,” she said.

Don St. Jacques, senior vice president and chief operating officer of Jopari Solutions, which supplies the e-bill processing for Mitchell, maintained the Minnesota deadline is a challenge but that experience in Texas shows the job can be done.

“The good news is timely compliance is not a major hurdle, but delayed action is not recommended. In Texas, for example, where e-bill regulations went live January 1 this year, many carriers and providers waited until the last minute. They had to request Department of Insurance waivers, and are now scrambling to find solutions because the waiver period is running out,” said St. Jacques.

St Jacques advised the attendees that Minnesota’s time frame “probably rules out home-grown solutions.” He said most auto insurers probably do not want to internally develop the necessary medical bill automation and connectivity with the medical community. “Regardless of strategy, however, early adopters will avoid compliance risks,” he said.

Tom McCarthy, executive vice president of Mitchell and founder of Mitchell Medical, said his company’s product provides auto medical claim connectivity with provider groups in Minnesota and nationally, including more than 60 percent of emergency rooms, hospitals, provider networks and ancillary medical practices.

Sources: Mitchell Medical
Mitchell International

Jopari Solutions, Inc.

Was this article valuable?

Here are more articles you may enjoy.