Capital District Physicians’ Health Plan, Inc. Partners with The SSI Group for Real-Time Eligibility Verification Technology
Mobile, Alabama, February 8, 2007 - Capital District Physicians' Health Plan, Inc. (CDPHP) of Albany, N.Y., has partnered with healthcare electronic data interchange (EDI) company, The SSI Group, Inc. (SSI), for an automated method of providing insurance eligibility and benefits information in 10 seconds or less to the health plan’s providers.
Through this partnership, SSI will host real time 270/271 processing technology for CDPHP, which will facilitate the health plan's delivery of real-time insurance eligibility and benefits information via the 270/271 HIPAA Transaction Code Sets. This project will help with the health plan’s objectives of:
• providing accurate and current eligibility information to healthcare providers and facilities
• managing and processing 270/271 transactions through a single source
• improving operational efficiencies
• providing increased flexibility, scalability and interoperability
• building a foundation that provides opportunities for implementing additional transactions
While CDPHP providers will still be able to receive eligibility and benefit information on the health plan's Website with a manual lookup, the new solution increases automation for those providers. CDPHP will now be able to accept HIPAA-compliant 270 eligibility inquiry transactions and respond with compliant 271 response transactions in fewer than 10 seconds. Additional benefits include detailed reporting functionality with standardized and ad-hoc reports.
"CDPHP is a valued partner of SSI, and we're proud to provide an automated eligibility and benefits solution to the healthcare providers and facilities needing their data," said Debbie Short, SSI's Chief Operations Officer. "Improvements with operational efficiencies and customer service will be realized by CDPHP, which were important components of their selection criteria when searching for a vendor."
SSI is the industry's first organization to receive CAQH Committee on Operating Rules for Information Exchange (CORE) Phase I rules certification seals, accomplishing the feat as both a clearinghouse and software vendor. By committing to CORE's Phase I rules, SSI pledged to electronically exchange patient eligibility and benefit information according to the CORE operating. These operating rules simplify the eligibility verification process, enabling healthcare providers to submit a benefit/eligibility verification request and receive a response within 20 seconds from CORE-certified healthcare organizations.
SSI's ClickON® Technology facilitates HIPAA transactions for claims (837I&P), eligibility request/inquiry (270/271), claims status request/inquiry (276/277), remittance advice (835) and precertification/authorization (278). ClickON's workflow capabilities automate the healthcare revenue cycle, enabling processing tasks to be accomplished in less time by fewer people.
About CDPHP™
Founded and guided by physicians, CDPHP and its affiliates currently serve members in 29 counties throughout New York state and seven counties in Vermont. In 2006, the Albany Business Review rated CDPHP the second fastest growing large company in the Capital District.
The four affiliated companies of CDPHP include a family of products: Capital District Physicians' Health Plan, Inc.—HMO, Healthy New York, Medicare Choice, Medicaid, Child Health Plus, and Family Health Plus. CDPHP Universal Benefits Inc.® —PPO, High Deductible PPO, POS, and EPO. Capital District Physicians' Healthcare Network, Inc. —self-insured plans; and APA Partners, Inc. —third party administration (TPA). Visit CDPHP at www.cdphp.com. |
|
Toll Free: 800-880-3032