HLTH21: Blue Shield of California, Google Cloud team up to take on claims management

Google Cloud
Blue Shield of California and Google Cloud are looking to simplify and automate claims processing in a new partnership. (Getty Images/Sean Gallup/Staff)

BOSTON—Blue Shield of California and Google Cloud are joining forces to build a new, scalable cloud platform that aims to automate and simplify the medical billing process.

The tool will digitize claims using automated processing, artificial intelligence and machine learning technologies. This should significantly improve accuracy and the timeliness of billing and payment data, Blue Shield executives said.

The project is part of Blue Shield's wider Health Reimagined initiative, the payer's broad effort to transform care.

The platform will also integrate solutions from the payer's other technology partners, executives told Fierce Healthcare. Aashima Gupta, director of Global Healthcare Solutions at Google Cloud, called it an "ecosystem of partnership."

Lisa Davis, senior vice president and chief information officer at Blue Shield, told Fierce Healthcare the insurer landed on Google as a partner after finding the two companies shared a similar vision around improving claims management and processing.

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"Google was really excited about what we wanted to do in transforming healthcare, and was aligned to the goal we had put forth," Davis said.

Davis said the platform is first being tested with a large health system as well as Altais, a medical group the insurer backs. She said that as the goal of the initiative is to make things simpler and frictionless for the provider, Blue Shield and Google will be taking feedback from the early adopters to learn more about what it will take to scale it.

Over time, the insurer is planning to expand the platform to all of its providers, plan types and categories of processed claims, according to the announcement.

Blue Shield noted that a 2019 study found that of the $3.6 trillion spent on healthcare each year, $265.5 billion is wasted in administrative overhead. Much of that bloat is in claims payment, which can leave patients confused about what they'll have to pay at the doctor's office.

Gupta said each component of the project is powerful, but when combined they have the strength to drive significant change. Cloud technology democratizes data, she said, and healthcare data have tremendous power. Artificial intelligence is a key building block for this work.

"Together, it's transformational," she told Fierce Healthcare. "Each one is unique in value."

Both Davis and Gupta noted that the technology for this initiative is out of the member's line of sight, and they will never need to interact with it directly. However, they'll feel the benefits of speedier claims processing, too, as they'll get information more quickly.

"That’s really a part of the strategy," Davis said. "Health Reimagined is about changing that member and provider experience."