Concord, CA – Despite political wrangling over Obamacare in Washington and ongoing technical problems with the roll out of the federal Healthcare.gov health plan marketplace, important components of the Affordable Care Act are changing the way all medical Providers and Payers interact. According to Jopari Solutions, a principal supplier of integrated medical transaction EDI services to the Property and Casualty industry, ACA components aimed at reducing the enormous administrative burden of medical care are already influencing the Property & Casualty industry, particularly Workers’ Compensation.
Stated J.R. “Steve” Stevens, CEO of Jopari: “The Group and Commercial claims industry has been espousing end-to-end electronic connectivity for a number of years. EDI based transactions such as patient registration, eligibility confirmation, claims submission and payment processing in that industry have demonstrated lower operating costs than the P&C claims industry incurs for the same types of interactions between Providers and claim staff. There is no question reliance on end-to-end connectivity eliminates a great deal of administrative frictional cost. Clear audit trails get established, allowing all parties to focus on their part of the revenue cycle continuum instead of trying to manage each other.”
“While rapidly growing acceptance of eBilling in the Workers’ Compensation industry — and now also beginning to take hold in the Auto Medical arena – parallels ACA reform objectives and is important to improving operational metrics, it is just one piece of the puzzle,” continued Mr. Stevens. “Equally important is the fact jurisdictional authorities are starting to leverage other ACA mandates, such as Electronic Funds Transfer (EFT), to create for Workers’ Compensation the same comprehensive end-to-end transactional relationship required under the Act.”
Jopari indicates the federal HHS rules going into effect 1/1/14, mandating Group and Commercial health plans offer EFT to their Providers, are already spilling over into the P&C marketplace, where Providers are looking for every possible way to streamline their operations and cut costs. ACA equivalent EDI technology has become essential to the P&C industry to be able to level the playing field with Group Health as far as easing the costs of administration, with the prime example being Jopari’s full suite of EDI transaction tools enabling eBilling, electronic payment processing including EFT and integrated paperless workflow.
Jopari provides nationwide connectivity to thousands of Providers and their systems (the myriad of Practice Management Systems, Clearinghouses, and Billing Services), enabling hundreds of Payers to integrate end-to-end EDI transaction capabilities into their existing bill review and claims platforms. Jopari plays a significant leadership role as a key participant in Federal, State and industry efforts to embrace and adopt full EDI for the P&C industry.
Mr. Stevens concluded, “Our organization is keenly aware we benefit by ensuring that we implement the federal standards to meet the unique needs of P&C insurance. Our collaboration with the various standards setting organizations, industry trade groups and jurisdictional authorities is a crucial aspect of our client service. We take this responsibility very seriously in order to ensure we all achieve the intended Administrative Simplification goals of ACA, allowing our clients to focus on their core operations without chasing paper.”
Source: PRNewswire