Texas Mutual Insurance Co., a workers' compensation insurer, has signed a new multi-year eBill Processing agreement with Jopari Solutions, a supplier of electronic billing solutions to Property and Casualty Industry Payers nationally.

According to Texas Mutual, eBill penetration continues to rise and related automated processing has lowered the turn-around time for payments by 33%.

"From the outset, Texas Mutual's compliance with eBill regulations has been critically important in terms of reinforcing our market leadership and establishing an operationally efficient model under the industry's first eBill regulatory framework,” said Kim Haugaard, Texas Mutual VP, Network & Medical Operations. “Our Processing Agent relationship with Jopari has been a key factor in capturing participation of providers, keeping our processing costs low and establishing an eBill technology solution that works. Texas Mutual and Jopari are working together to add more provider connectivity solutions to the mix, which has been the key factor in the adoption rate. Renewing our relationship with Jopari allows us to continue to build on our success."

"Jopari supports Texas Mutual's commitment to leveraging eBill technology," offered Steve Stevens, Jopari CEO. "It is a privilege to work with Texas Mutual, and we consider it a highly successful partnership. Jopari is assisting many major health care organizations to migrate from paper to electronic billing, and we are reaching the point where most claim critical aspects of medical billing can be electronically transmitted. A foundation of strong payer and provider connectivity and technology that works for both sides leads to lower costs for all."

Pursuant to renewal of the agreement, Texas Mutual and Jopari also will focus on the impact changing HIPAA standards will have on workers' compensation medical treatment, handling protected health information under new business associate conditions, and assimilation of ASC X12 version 5010 transaction sets.

Texas Mutual initially selected Jopari to be the Company's eBill Processing Agent in 2007 in response to the Texas Department of Insurance implementation of workers' compensation electronic medical bill requirements. Texas was the first jurisdiction to adopt HIPAA conforming electronic formats for electronic medical bill processing, supported by a specialized EDI infrastructure incorporating Processing Agents to manage connectivity arrangements with health care providers to automate claim indexing, attachment throughput, provider bill status inquiries, and electronic remittance distribution.

Following Texas' lead, additional jurisdictions have since initiated regulations addressing exchange of electronic medical transactions that incorporate the Texas eBill Processing model. National standards organizations – including the IAIABC, WEDI and DISA (X12) – are also promoting uniform national eBill standards based in large part on the Texas guidelines for administering electronic medical bill submission, reimbursement and documentation.

 

Register or login for access to this item and much more

All Digital Insurance content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access