Blue Shield of California and Google Cloud announced this week that they are collaborating to launch a new approach to paying providers, aimed at processing members’ claims in real time.
The companies say they will use automated processing, artificial intelligence and machine learning software on a cloud platform to digitize healthcare claims and improve the accuracy and timeliness of billing information.
“Our collaboration leverages the best of both companies – Blue Shield of California’s deep healthcare experience and commitment to improving the health of its communities and Google Cloud’s ability to develop and automate scalable technology,” said Aashima Gupta, director of Global Healthcare Solutions at Google Cloud, in a statement.
WHY IT MATTERS
The health claims payment process in its current incarnation can take days – leaving providers wondering when they’ll be paid for services, and members wondering how much their medical care will cost.
The collaboration aims to provide instant information on out-of-pocket costs and Blue Shield payments, while addressing existing spending on administrative complexity.
“This plan to provide clear, concise and correct medical billing information will lead to the creation of a national model to make all healthcare billing instantaneous and understandable, removing friction points for consumers and providers,” said Gupta.
Blue Shield says it will standardize its datasets and scale its ongoing automated billing efforts by integrating Google Cloud technologies and those from the health insurance company’s other tech partners.
Over time, Blue Shield plans to expand the initiative to all providers, plan types and categories of claims processed, as well as to health information exchanges.
“The goal is to simplify the billing and payment process for providers so they can spend more of their time on patient care,” said Lisa Davis, senior vice president and chief information officer at Blue Shield of California, in a statement.
THE LARGER TREND
Major payers have turned to health IT innovators to try to streamline the claims process over the past few years, with an eye toward promoting transparency and cutting down on costs.
For instance, the Blue Cross and Blue Shield Association licensee Health Care Service Corporation announced in June 2020 that it is working with electronic health record vendor Epic to build a bidirectional exchange platform to connect payers with providers.
The year before, Epic competitor Cerner partnered with patient financial experience company Simplee to offer consumers a more transparent and personalized healthcare billing process.
ON THE RECORD
“We are reimagining healthcare by providing instant billing information that is digital, personalized, transparent and easy to understand,” said Davis.
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