Plan offers real-time claims adjudication

The South Carolina Blues hopes that a card reader will spur instant electronic transactions, which are rarely available now.

By Tyler Chin, AMNews staff. Aug. 22/29, 2005.

Companion Technologies, a health care technology company owned by BlueCross BlueShield of South Carolina, began marketing a card-reader machine to physicians that will enable them to collect money from patients both coming in and going out the door.

When a patient checks in, physicians can use the machine to determine insurance eligibility by swiping the patient's magnetic stripe health insurance card, or keying in the patient's identification number and birth date on the device.

Assuming the patient is insured, the device then lets the physician office know the amounts for co-payment, deductible and coinsurance, said Harvey Galloway, president of Companion Technologies.

As the patient is being checked out, the physician's office can submit claims and have them adjudicated in real time through the device, as long as the patient's insurer has real-time claims adjudication capability, said Deryl Metze, vice president of electronic data interchange at Companion Technologies.

If the insurer has that capability, physician offices using the device will know exactly how much a patient owes and how much the insurer will pay them before the patient walks out the door, Metze said.

Companion Technologies expected to begin marketing the device, which also handles credit and debit card transactions, in South Carolina starting Aug. 15, followed shortly thereafter by a national rollout.

Physicians would have to pay $19.95 a month per device plus 20 cents per transaction. They would not be required to buy the device to remain with the Blues plan.