AETNA: New Electronic Payment System For Physicians
Aetna U.S. Healthcare yesterday launched E-Pay -- a "groundbreaking" electronic claims processing program that will pay physicians within 15 business days if they submit HMO referrals and claims electronically (Aetna U.S. Healthcare release, 6/15). According to the Wall Street Journal, the new program "comes at a time of growing complaints that managed care companies are dragging their feet when it comes to paying doctors." Payment backlogs, the Journal reports, reflect the fact that the trillion dollar health care industry "remains years behind" other fields like banking and retail in its use of electronic transaction technology. "There's nothing whiz-bang [in E-Pay]. It is really just using a lot of technology available today that the health care system isn't utilizing," said David Kirshenbaum, general manager of electronic commerce at Aetna. The Journal notes that about 38% of physicians nationwide use electronic claims systems, "roughly in line with Aetna's own experience." The health care giant says it is simply offering the financial incentive of getting paid sooner so that more physicians will take advantage of a system that is less labor-intensive and less error-prone. "We're telling the doctors, 'We'll pay you in 15 business days if you start making the system work better,'" said Kirshenbaum. The company also expects to increase efficiency by eliminating the duplicate claims it receives as a result of delays (Winslow, 6/15).
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Aetna said the new system will pair electronic claims with corresponding referrals and route them into the payment process. In addition, Aetna expects E-Pay to improve service levels and increase cost-effective connectivity with participating physicians across the country. Physicians will have several options, including voice response units and swipe card boxes to electronically submit claims or confirm referrals and eligibility; desktop systems with software for claims submission; and training for each option. Aetna will distribute the software free to all participating doctors. The program will be made available initially to doctors in New York and northern New Jersey on July 15, and is expected to be rolled out nationally next year. Michael Cardillo, president of Aetna, said: "We believe that E-Pay will improve HMO claim turnaround time leading to more predictable cash flows for physician practices and therefore higher satisfaction levels among our participating physicians." IBM Global Healthcare's Neil de Crescenzo said, "the nicest part of e-business in this industry is that it will ultimately help improve the practice and delivery of health care to the benefit of doctors and their patients" (Aetna U.S. Healthcare release, 6/15).