Multiple industry publications took note of our Oct. 18 announcement that Blue Shield of California is working with Google Cloud and other partners to speed claims processing and payment.
The companies will digitize healthcare claims using automated processing, artificial intelligence, and machine learning technologies to greatly improve the accuracy and timeliness of billing information and claims payment.
This collaboration will transform the member experience by providing instant information on out-of-pocket costs. The initiative, a part of Blue Shield's broader Health Reimagined strategy, will also allow providers to understand the payments they can expect from Blue Shield and eliminate burdensome administrative processes.
In an Oct. 19 story, MedCity News wrote:
The solution will extract clinical data from the provider’s EMR and then codify that record into a digital claim for billing, said Lisa Davis, senior vice president and chief information officer at Blue Shield of California. The payer will adjudicate that claim and send back a claim settlement decision to the provider, which will be shared with the patient in near real time.
“Today, we all have an experience where we leave the doctor’s office, and we have no idea what we’re paying for,” Davis said in a phone interview. “We get this cryptic letter that says you have received ‘X’ services…and there is a cost associated with that. So, imagine being able to create…a retail-like experience where I go into the doctor’s office, I know exactly what I am paying for, I know exactly what those costs are.”
The companies have proved out a pilot case where the entire process, from extracting the clinical data to sending back a claim settlement decision, is done in less than 10 seconds, Davis added.
Read the full story here.
On Oct. 20, Fierce Healthcare wrote:
Over time, the insurer is planning to expand the platform to all of its providers, plan types and categories of processed claims, according to the announcement.
Blue Shield noted that a 2019 study found that of the $3.6 trillion spent on healthcare each year, $265.5 billion is wasted in administrative overhead. Much of that bloat is in claims payment, which can leave patients confused about what they'll have to pay at the doctor's office.
Read the full story here.
The effort with Google Cloud and Blue Shield also was reported on by Healthcare IT News.
Lisa Davis, chief information officer at Blue Shield, also talked about the effort with Eric Glazer in the Bright Spots in Healthcare podcast.