Filing Medicare claims has always been a laborious process for healthcare facilities. Yet it couldn’t be more important to how these organizations get paid. So how do you find ways to improve and update the process?
A software development contest is trying to answer that question.
Teams from Zenithech LLC, Avanade Inc. and Big Yellow Star have won the Medicare Claims Data Developer Challenge sponsored by IMPAQ International LLC and the National Opinion Research Center (NORC) at the University of Chicago, Health 2.0 announced in a press release.
The contest encourages companies to develop interactive Internet-based tools to make Medicare claims data more accessible and usable for clinicians, health researchers, consumers, policy-makers, entrepreneurs and others.
To enter, software developers, entrepreneurs and technologists were asked to create online tools allowing users to access at least one of the eight public use files (PUF) covering 2008 Medicare claims data, in categories like inpatient, durable medical equipment, hospice, carrier line, home health, Medicare Part D, outpatient and skilled nursing facility.
Judging involved weighing how well the applications met Medicare claims data challenges, usability, and whether the application could be integrated with existing claims systems or other health technology platforms.
Disrupted processing can cost healthcare organizations time away from patients, reduced revenue and increased costs.
"The ingenuity, innovation and creativity the participants demonstrated were exceptional," said Indu Subaiya, co-chair and CEO of Health 2.0, which collaborated with IMPAQ and NORC. "The tools they created will facilitate and foster exciting research that will drive new ideas and approaches to improve quality of care, lower costs and shape health policy. It was a tough competition, and we congratulate the winners."
In 2009 the American Medical Association (AMA) produced a report discussing the strengths and weaknesses of the claims processing systems used by the nation's largest health insurers.
The report added that the “inefficient and inconsistent claims process adds as much as $200 billion annually to the healthcare system.” And that was three years ago!
Another study estimated physicians cumulatively spend as much as three weeks annually on health insurer red tape. To keep up with the administrative tasks required by health plans, physicians give up as 14 percent of their revenue to ensure accurate payments from insurers, according to the AMA.
Edited by
Braden Becker
