3. the entity that owns the contract with the physician applicable A More Secure Way to store files 500+ medical billing o ces nationwide use eBridge’s HIPAA-compliant, secure cloud-based document management system to streamline operations, save money, and reclaim space. t Provider scanning and retrieval t E! ortless work queue management t Quick and easy batch scanning t Compliant audit trails to track user access t Full-text keyword searches for ultra-fast retrieval Call 813-387-3870 today for a demo. Because your business is about more than just paper. the journal of the healthcare billing and management association 33 to the claim 4. the fee schedule that applies to the claim 5. the specific plan/product type 6. the location where the claim is to be sent 7. any applicable secondary or tertiary payors who may have financial responsibility for all or part of the claim currently, billing companies, patients, physicians, and other health care providers must either contact the health plan directly or request the information before patient treatment is delivered, and/or be forced to contact the health plan after payment is received to ascertain if the contractual agreement was fulfilled. ambiguity and manual intervention contribute to higher costs for everyone. clear identification of each organization, plan/product type, and the specific fee schedule involved in the determination of the ultimate patient benefit and claim payment will result in transparency gains that will benefit billing companies, patients, payors, physicians, and other providers, as well as contribute to a decrease in healthcare costs for the entire industry. Automating Coordination of Benefits the hPid/oeid will also enable automation of the coordination of benefits (cob) process by ensuring that billing companies, physicians, and other health care providers always have access to all relevant payor ids, whether they are primary, secondary, or tertiary. cob is the process of coordinating the adjudication of a claim between two or more payors that both have financial responsibility for health services being rendered. the adoption of an hPid and oeid to include provider networks, tPas, and other entities involved in a claim transaction would facilitate identification of the various payors. this will lead toward the automatic identification of secondary payors, thus facilitating the automated generation of claims to secondary payors or a medicare supplemental plan, reducing the burden on the patient or beneficiary, and eliminating the need for physicians and other health care providers to generate paper claims, which contribute to higher transaction costs and increased risk of error. Visit www.ama-assn.org/go/simplify for white papers and additional information regarding AMA’s administrative simplification initiatives. www.eBridge.com 813-387-3870 LHaywood@eBridge.com
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