Hi;
 
My name is Bill Hagan and I am looking for some advice on a decision we are evaluating.
 
Today we are a company that processes 5 million claims with only about 10% electronic.
Obviously we want to move to electronic submissions and in fact not only submissions
but document exchange such as rosters, panels, remits, etc.
 
Currently we are working with WebMD and other clearinghouses to capture the claims.
However it is expensive somewhere from .29-.35 cents a transaction. So I am looking for
realistic and cheaper alternatives. In addition, since WebMD performs editing we
have no visibility to "dropped" transaction and this is an irritant to our providers.
 
Ideally we would like to go direct and implement out own transaction engine or something
similar. I have been told that providers only like to have one connection (that being a clearinghouse)
and that they will not switch.
 
So my question is --- IS that TRUE in your estimation. If so, what incentives have you seen used to
go direct. And finally, what tools would you recommend. We are looking at bTrade, Cyclone Commerce
and IP-Net. Because of the logging, mailboxing and non-repudiation, these seem to be a good
fit with HIPPA but they too are very expensive and we would like to know if there are other
alternatives.
 
You can give me a call if you like at 602-757-8466 and I have provided my company
e-mail address if you would like to contact me that way.
 
I appreciate any advice or counsel you can give.
 
Thank you
 
Bill
 
 
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