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BUSINESSAlliance formed to develop information-exchange rulesOne of the group's goals is to standardize health plans' electronic patient eligibility and benefit data, so that physicians have quicker access to better information.By Tyler Chin, AMNews staff. June 27, 2005. More than 50 medical societies, insurers, hospitals and technology companies have launched an initiative designed to make it easier for physicians to obtain patient insurance information electronically. Under the initiative, members of the alliance, including the American Medical Association, will develop information-exchange rules to enable doctors to submit an electronic eligibility inquiry regardless of the billing system they have in their office to learn which participating health plan covers that patient and that patient's co-payment and deductible, said Robin Thomashauer, executive director of the Council for Affordable Quality Healthcare. The Washington, D.C.-based nonprofit coalition of the nation's largest health plans and networks is spearheading the initiative. It is modeled on the process the financial industry used to develop information-exchange or operating rules that enable customers of one bank to withdraw cash from any automated teller machine whether or not that ATM is owned or operated by their banking institution, Thomashauer said. "CAQH should be commended for reaching out to physicians in this important initiative to solve a vexing problem that has demanded a solution for some time," said AMA Chair J. James Rohack, MD. "This will go a long way in alleviating physicians' frustration with health plan administrative operations. We are optimistic that the next step in this endeavor will yield accurate, real-time information detailing patient-specific cost-sharing responsibilities and health plan payments to physicians." [...]Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2005 American Medical Association. All rights reserved.
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