Enhancements to claims platform aimed at supporting electronic attachments
Change Healthcare is adding new enhancements to its claim attachments solution that will enable providers to attach and send documents and data electronically to all payers.
“We’re tackling the next frontier of electronic transaction adoption in the healthcare industry,” says Mike Peresie, senior vice president and general manager of the medical network at Change Healthcare. “This enhanced claim attachments solution addresses long-standing issues that have resulted in paper-based processes and inefficiency. By adopting our claims attachment solution, payers and providers can end their reliance on antiquated solutions, take paper out of the system, and participate in the next phase of industry maturation powered by artificial intelligence.”
Currently, providers use a host of fragmented workflows and paper-based processes to exchange clinical and other supporting documentation with payers, Peresie says. The industry still has a long way to go when it comes to enhanced claim attachments, but “we’re seeing a lot of momentum right now.”
ANSI Standard 275—known as the “Additional Information to Support a Health Care Claim or Encounter”—is used to send attachments related to a healthcare claim, and it’s providing a stepping stone for broader interoperability between payers and providers, Peresie says. “It’s dramatically more efficient.” Currently, Change Healthcare is processing “hundreds of thousands of 275s a month, with a lot of payers and providers showing an interest,” he says.
Peresie believes adoption of electronic attachments can be driven through an expanding network. “Any time you roll something out, having a broad network is a huge help in making that happen,” he says.
According to Change Healthcare, it’s Intelligent Healthcare Platform is one of the largest clinical and financial healthcare networks in the U.S., processing nearly 14 billion healthcare transactions and approximately $1 trillion in adjudicated claims, or approximately one-third of all U.S. healthcare expenditures.
With healthcare continuing to struggle with interoperability, the growing use of the 275 standard might be part of a solution. Change Healthcare says benefits to using its new platform include increased provider efficiency, error reduction, improved manageability and improved cash flow.
The total national savings potential created through the adoption of electronic claim attachments is estimated at more than $200 million, according to the latest report from CAQH, a non-profit alliance focused on creating shared initiatives to streamline the business of healthcare.
Change healthcare’s new claim attachments solution also sets the stage for new uses of artificial intelligence technology, according to Peresie. Change Healthcare is already applying AI to automate medical documentation review for risk adjustment and payment integrity use cases. While it often takes 40 minutes or longer for humans to review a medical record for coding accuracy, AI is able to read and process the same medical record in just 40 seconds, according to internal metrics captured by Change Healthcare.