BUSINESSDeal expands real-time claims adjudicationA joint venture is struck to get more physicians and health plans to settle claims quickly.By Jonathan G. Bethely, amednews staff. July 10, 2006. Two health-plan-owned electronic processing ventures are melding into one in an attempt to rev up the development of real-time claims adjudication -- settling the insurer's and patient's share of payment before the patient leaves the office. The joint venture combines Jacksonville, Fla.-based Availity, an Internet-based claims processing company operated by Humana and BlueCross and BlueShield of Florida, and The Health Information Network, or THIN, an electronic claims processing company based in Dallas and operated by Health Care Service Corp., which owns Blues plans in Illinois, New Mexico, Oklahoma and Texas. The venture, operating under the Availity name, expects to handle 330 million transactions, representing $50 million in revenue, over the course of the next year. The venture -- which is not being called a merger, because Availity is acquiring THIN's contracts, not its assets -- is awaiting antitrust approval, expected to come sometime over the summer. The deal would expand Availity's network of 14,000 doctors and hospitals by an additional 120,000 doctors and hospitals. Availity has been an early leader in developing software for real-time claims adjudication, which THIN does not currently offer. Availity CEO Julie Klapstein said physicians who contract with one of plans in the joint venture would receive the company's Internet software free of charge. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2006 American Medical Association. All rights reserved.
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The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment. Meeting coverage - Slideshow Feature articlesHealth reform review The Massachusetts experience Litigation stress Being sued is personal as well as professional Comprehensive coverage
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