Consumers Life Offers Real-Time Claims Processing System

Thu Nov 5, 2009 12:31pm EST
 
[-] Text [+]
ATLANTA, Nov. 5 /PRNewswire/ -- Consumers Life of Georgia has developed and
piloted its own Real-Time Claims Adjudication (RTCA) system to enable patients
to instantly take care of financial obligations at the point and time of their
medical care.

Introduced in October 2008, RTCA was piloted by four physician offices.
Feedback from the physicians of varying specialties indicates that the system
is easy to use and patients too find it easier to conduct business at the
point of service.

"The results are encouraging," said Rich Waldron, Consumers Life vice
president of Network Management. "As for expediency, the claims submitted are
fully adjudicated and returned to the physician and member in seconds," said
Waldron.

The web-based RTCA system was developed in-house by Consumers Life parent
company Medical Mutual and mirrors the layout of a claim form. The system
provides users with the status of a completed claim within seconds of
submission. The resulting documentation is an Explanation of Benefits (EOB),
which is printed and provided to the member for his/her records.

The RTCA system was integrated into Consumers Life's Provider e-Portal earlier
this month, allowing all network physicians to utilize the system. In
addition, an internal RTCA steering committee is monitoring progress made on
claims cost estimators, which may be coupled with the RTCA system to offer
additional value to Consumers Life providers and members alike. RTCA and the
upcoming claims cost estimator will be accessible through Consumer Life's new
Provider e-Portal, or the members' My Health Plan website
http://www.consumerslife.com/

"This is an important step for our customers and provider clients because, as
the transformation of the healthcare marketplace continues, Consumers Life
recognizes that consumerism and transparency will be significant components,"
said Waldron. 

Consumers Life Insurance Company is a subsidiary of Medical Mutual, the oldest
and largest health insurance company based in Ohio.  The company is licensed
to sell health insurance products in 28 states and the District of Columbia. 
Consumers Life serves its customers through high-quality, affordable group and
personal health insurance plans, and third-party administrative services to
self-insured businesses.  For more information, visit the company's Web site
at ConsumersLife.com.

SOURCE  Consumers Life

Ed Byers, Manager Media Relations, Consumers Life, +1-216-687-2685,
ed.byers@mmoh.com

 

Featured Broker sponsored link

Editor's Choice

A selection of our best photos from the past 24 hours.  Slideshow 

Most Popular on Reuters

  • Articles
  • Video