BCBS of Michigan to Expand EDI Portal

Detroit–Blue Cross Blue Shield of Michigan (BCBSM) says it plans a significant expansion of its health care electronic data interchange clearinghouse and portal.

Beginning in early 2008, BCBSM will add traditional Medicare eligibility and benefit information to its online clearinghouse and portal, enabling Michigan physicians and hospitals to go to the portal to check and verify benefits and coverage for beneficiaries enrolled in traditional Medicare.  The enhancement will offer medical providers secure access to critical benefit information via BCBSM’s single Web portal. The enhanced portal information will combine traditional Medicare eligibility and benefit information to already existing benefit and eligibility information on individuals enrolled in BCBSM, Blue Care Network and Medicaid plans — all through the same online connection. With the addition of Traditional Medicare benefit and eligibility information, the vast majority of insured lives in Michigan will become available to medical providers seeking eligibility and benefit information anytime through the BCBSM portal.

“These enhancements are in support of a statewide initiative by Gov. Jennifer Granholm, the Michigan Legislature and other public and private organizations to make Michigan a leader in health information exchange,” says Mary Smith, BCBSM vice president of health care delivery strategy. “Providing vital information in one place instead of multiple sites helps ease the administrative burden for medical providers.”   

BCBSM is participating in the statewide initiative on health information exchange, which seeks to improve quality and efficiency of health care delivery by minimizing redundant data collection, meeting national standards for information exchange, encouraging patient centered care and promoting patient safety and quality.

“BCBSM plans to keep on expanding online access features for physicians through our portal, which is an electronic gateway that enables health plans and providers to transact business,” says Joe Hohner, BCBSM vice president and chief information officer.

The BCBSM electronic data clearinghouse is expected to process 200 million BCBSM, Medicaid and other health insurance transactions in 2007, including eligibility and claims information. The portal, used by medical providers, is expected to process an additional 70 million inquiries or transactions.

Called web-DENIS, the BCBSM provider portal has been adopted and used by more than 30,000 Michigan physicians and other providers, all Michigan hospitals and medical facilities and medical billers. The system is used by nine out of 10 physician offices in the state.   

Source: BCBSM

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