The Healthcare Administrative Simplification Coalition issued a final report today. According to a press release, the report
HASC includes the American Academy of Family Physicians, the American Health Information Management Association, the Medical Group Management Association, and CMS among others.
outlines a plan for physician practices, hospitals, insurance payers, benefits managers and others to voluntarily adopt a coordinated nationwide approach to conducting key administrative processes for:
- Credentialing physicians and other clinicians – A universal credentialing form would eliminate hundreds of hours of repetitious paperwork that physician practices now devote to completing multiple credentialing forms for insurance payers, hospitals and others.
- Determining and verifying patient eligibility for health insurance – Adoption of an industry-wide standard for interchangeable electronic data would help hospitals and physician practices determine each patient’s insurance coverage more quickly and accurately.
- Standardizing healthcare patient identification cards – Standardizing the design and content of patient ID cards, and ensuring they are machine-readable, would significantly reduce costly errors and delays in the medical claims billing process.
- Improving coordination of prior authorization processes for radiology and pharmacy services – A voluntary, standardized approach to how providers request and receive determinations of patient eligibility for pharmacy benefits and radiology services would reduce treatment delays and reduce costly paperwork.
Last week, United Healthcare and Aetna each won Tricare contracts. TRICARE is the health care program serving active duty service members, National Guard and Reserve members, retirees, their families, survivors and certain former spouses worldwide. Aetna beat out Health Net for the Tricare North region contract. Today Healthnet announced that it is selling its Northeast operations (Connecticut, New York, and New Jersey) to United Healthcare. Health Net will focus on its operations in Arizona and the West Coast. According to the Minneapolis Star Tribune,
The Star Tribune also reports that Health Net has protested the Tricare contract award to Aetna.
UnitedHealth will pay Health Net $60 million for the Medicare and Medicaid businesses and renewal rights for the commercial membership. After the closing, UnitedHealth will transfer $290 million to Health Net, with another $160 million to be transfered over the next two years.If all commercial members end up renewing policies with UnitedHealth, UnitedHealth could pay Health Net up to an additional $120 million.