N.C. Blues plan uses hospital-based staff to clean up claims

Blue Cross and Blue Shield of North Carolina (BCBSNC) in Raleigh has been able to achieve first-day resolution of more than half of its claim inquiries at the private, not-for-profit health system WakeMed Health and Hospitals--23 percent better than the previous year. In addition, the health insurer has been able to cut in half WakeMed's submission of paper-based complex and secondary claims. The key to BCBSNC's success is on-site claims staff, reports the Triangle Business Journal. BCBSNC launched a similar program with the University of North Carolina Health Care System in December and could add additional hospitals or physician groups later this year. Article