Bank One Links Insurers, Providers

October 3, 2003
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GRAND RAPIDS — Bank One has introduced a new product that assists health care insurers and providers in processing electronic transactions in compliance with new Health Insurance Portability and Accountability Act (HIPPA) regulations.

All health care organizations that process transactions electronically must comply with the HIPAA standard, effective Oct. 16.

Bank One’s Healthcare Link is a patented health care payment and transaction processing system and the first bank product of its kind to achieve certification from Claredi, a third party certifier of HIPAA transactions and a leading independent provider of HIPPA compliance testing.

Bank One started developing Healthcare Link in September 2002 and introduced it to the market just six weeks ago. It has been spreading the word about the product through a series of “live” informational meetings staged across the markets it serves.

In conjunction, the bank also launched a “Webinar” campaign online on Aug. 20 and unleashed a sales force of about 100 bankers to spread the word further.

Webinars are held every three weeks and about 30 to 40 customers attend each one, said John Prince, senior vice president and head of the bank’s Healthcare Business Development and Strategy division.

About 30 different customers have attended each live presentation and one in three of them have signed up for the product, Prince said.

Though no customers have fully implemented Healthcare Link as yet, a number of them are in the process of doing so, he said.

“Most of the insurers are not able to do the transactions until Oct. 16, so there’s a huge market already poised to implement it. There’s a lot of activity right now because HIPAA regulations go into effect Oct. 16 and there’s a huge interest in the market regarding what to do.”

If a hospital or physician group signs up for the Healthcare Link solution, Bank One contacts their insurers and transitions their payment system from paper to electronic, Prince explained. It then works with customers on customizing their file formats so data is delivered in whatever format they choose.

For a hospital or physician, the typical transaction involves a check from the insurance company and lot of information regarding explanation of benefits.

That costs the provider between $6 and $9 to process, Prince said.

A typical hospital has 15 to 20 people whose sole job is to post payment, he explained. They look at the claims and enter all the information into the hospital’s accounts receivable system.

“We completely automate that so there’s no more manual entry. We cut out about 80 percent of the cost. That’s why we’ve gotten such phenomenal reaction in the market.”

Prince said that besides lowering transaction costs, Healthcare Link reduces reconciliation challenges.

“When it’s done electronically, we automatically run all the checks and balances on each transaction, so when we deliver a file to our customer, it has already been reconciled and balanced.”

All the other electronic solutions on the market right now don’t link payment and remittance information, he said.

“Our solution is unique in that we actually hold all adjudicated claims until we receive payment, so the file we deliver to the hospital or physician group each day only has claims that they’ve been paid for.”

“The typical hospital might have a couple hundred thousand claims to process every year, so you’re looking at a significant challenge of really reconciling all the claims that have been adjudicated by the insurance company and the payment is coming in.”

Healthcare Link was designed for a full range of health care providers, from small private medical practices to large metropolitan hospitals.

“It doesn’t matter if you’re running 100,000 transactions a month or 100,” Prince added.

He underscored the fact that Medicare announced Tuesday that only 15 percent of claims being submitted are compliant with HIPAA.

Prince said Bank One is probably one of the only banks that has an entire group dedicated to building new solutions for the health care industry. Healthcare Link is one of five new businesses serving the health care industry that Bank One has launched in the past year, he noted.

“The health care industry for the bank as a whole is one of the major focus areas,” Prince observed. “We work with 750 hospitals and a couple thousand physician groups in the U.S. and eight of the 10 largest insurers. We move the majority of the Medicare payments in the U.S. This is part of a broader plan to serve that market.”

Healthcare Link, he said, will evolve over time to include additional business processes and solutions for customers in the health care industry.    

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