CONCORD, Calif. /PRNewswire/ — The announcement on Tuesday by the California DWC that the much anticipated eBilling rules have now been signed into existence not only is an opportunity for providers and payers to more effectively manage medical billing processes, but also represents a number of years of collaboration between a wide array of stakeholders, explains Sherry Wilson, EVP and Chief Compliance Officer for Jopari Solutions. Jopari is a leading supplier of eBilling and payment technology for the Workers’ Compensation industry, connecting thousands of providers and hundreds of payers nationally.
Stated Wilson, “The cooperation between the California DWC, other eBill jurisdictions such as Texas and Minnesota, with active participation by trade and national standard organizations such as the IAIABC, X12, WEDI, and the California Medical Association, has produced jurisdictional rules that embrace national transaction standards which should facilitate the overall implementation process. These rules also reflect some of the specific needs of the California Workers’ Compensation system.”
The new California rules require payers to be able to accept electronic medical bills and their related attachments in 18 months. The rules also mandate changes to paper billing practices and data capture requirements within 6 months of the effective date, or October 15, 2011.
“We encourage payers establishing their plans to meet these paper requirements to maximize their efforts by incorporating their strategy for implementing electronic billing,” said Wilson. “In doing so, they can begin to achieve the operational benefits of eBilling that a growing number of payers and providers have been achieving in many jurisdictions through voluntary eBill acceptance programs for a number of years. When properly implemented, eBilling is a more efficient means for providers and payers to interact, with both sides realizing the benefits.”
According to Wilson, “With the California rules now in place, and with efforts of the International Association of Industrial Accident Boards and Commissions (IAIABC) and their model eBilling rule developed in 2010, we expect to see a number of additional jurisdictions release rules in the coming months.”
Also in the coming months, Jopari will coordinate with existing provider and payer clients who have business operations in California, while actively supporting the efforts of a number of organizations planning educational outreach on the new rules, including the DWC, the California Medical Association (CMA), and others.
Ms. Wilson concluded by saying “We applaud the efforts of the DWC and all of the stakeholders. The current focus on the federal Affordable Care Act, and in particular efforts led by the American Medical Association to reduce the estimated $200 billion of administrative waste in healthcare in such areas as billing, collections, and remittance management – highlight the need for these rule changes. Even though Workers’ Compensation is a small segment of total U.S. healthcare spend annually, use of electronic medical billing in the group health world has a proven track record for improving communications and coordination between providers and payers, and is now beginning to be realized in the Workers’ Compensation industry.”