Insurers Plan Online Claims Filing Service Via MedUnite
Seven large health insurance companies yesterday announced plans to jointly create an Internet-based, "one-stop clearinghouse" to expedite claims, referrals and other health care transactions between physicians and insurers, the Philadelphia Inquirer reports.
MedUnite's founding members -- Aetna Inc., Cigna Corp., Anthem Blue Cross and Blue Shield, Health Net Inc., Oxford Health Plans Inc., Pacificare Health Systems and Wellpoint Health Networks -- hope to streamline physician/insurer transactions, increase claims acceptance rates and reduce payment times by standardizing claims forms among multiple insurers. MedUnite spokeswoman Eve Dryer said the service is designed to reduce the "hassle factor" plaguing doctors who deal with several different insurers, each with their "own forms, eligibility requirements and preferred modes of operation" (Knox, Philadelphia Inquirer, 11/15). Services that MedUnite would process online, such as payment claims, patient referrals and eligibility checks, are now mostly handled on paper or with private electronic networks. In addition, most physicians hire staff to handle these "time consuming" transactions (Carrns, Wall Street Journal, 11/15). MedUnite CEO Dave Cox said the joint business venture "would be the only business of its kind to offer doctors a way to use a single form to communicate with all of its member health plans." The system could also "inform doctors in real time that they have filed a claim form improperly, thereby eliminating months of delays and hassles as paperwork shuffles back and forth between doctors and health plans," Cox said (Bernstein, Los Angeles Times, 11/15). The seven MedUnite founding insurers currently insure about 61 million people, and "have relationships" with 26% of physicians and 37% of hospitals nationwide. Other companies will be able to join the MedUnite insurer base "as partners or as customers," Dryer said (Philadelphia Inquirer, 11/15). To join MedUnite, insurers would pay fees on a "per-transaction basis," and physician offices would pay a flat monthly fee for unlimited transactions. Although these fees have not yet been determined, Cox said the cost for doctors and health plans will be less expensive than systems they are currently using (Wall Street Journal, 11/15). If MedUnite can help reduce the more than $70 billion health plans spend annually on claims and referrals processing, health plans' stocks "will go sky high," according to Sheryl Skolnick, a health care analyst with New York-based Banc Boston Robertson Stephens. (Los Angeles Times, 11/15). San Diego-based MedUnite is set to begin a test phase in February with 500 physicians nationwide, and plans to be "fully operational" in June (Philadelphia Inquirer, 11/15).
The launch of MedUnite does not bode well for financially ailing competitor WebMD, unless the two companies can work together and merge their capabilities, the Wall Street Journal reports. Atlanta-based WebMD also is working to "link the health care industry's myriad parts over the Internet," and plans to provide similar services to insurers (Wall Street Journal, 11/15). MedUnite has an edge on WebMD, however, with a built-in customer base of its founding members, and has no plans to go public, thereby eliminating the need to post "huge profit[s] or please Wall Street investors," unlike WebMD (Los Angeles Times, 11/15). WebMD CEO Martin Wygod remains optimistic that WebMD is well-financed and positioned to compete with MedUnite, but is willing to work with its competitor where the companies' interests overlap. Wygod said, "We wish them well, and we hope to do business with them." MedUnite's Cox concurred, "It's in their interest and our interest to make these services work together." Cox did not disclose MedUnite's expected revenue or how much each founding insurer contributed towards the venture (Wall Street Journal, 11/15).