Tenn. Blue plan offers real-time claims adjustment

BlueCross BlueShield of Tennessee has become the latest health plan to address a key issue with high-deductible plans. Following in the steps of peers like UnitedHealth [1], the Blue plan has created a pilot program under which providers can find out, in real time, how much a patient owes, and collect on the spot. The pilot, which is already live in Chattanooga, is going to roll out statewide by this summer. Only 10 percent of the plan's enrollees are members of high-deductible plans at the moment, but consultants expect that figure to grow.

The BCBS plan's effort addresses industry-wide concerns over cash flow in high-deductible plans. Without such technology in place, providers might overcharge the patient, or might bill later and risk never getting paid at all, both of which have obvious downsides. But when other health plans have trialed the real-time claims adjustment approach, results have been good. Humana execs, for example, said one practice saved $14,000 in one year alone thanks to reduced billing costs.

To learn more about the effort:
- read this Nashville Business Journal article [2]

Related Article:
Solving the price transparency puzzle. Report [3]