Intelligent Validation from Healthcode promises faster payment for consultants and providers

Published: Thursday, 18 April 2013 17:08

A new service from Healthcode, the experts in online solutions for the private healthcare sector, promises faster payment for consultants and providers by eliminating billing delays. Bupa is the first private medical insurer to take up Intelligent Validation to enhance the efficiency of its payment process for consultants and providers.

Intelligent Validation technology works by checking the policy-holder information on the bill submitted by the provider against that on the insurer’s own database and recognising any discrepancies. It automatically corrects errors in the patient’s first name, surname or date of birth when the membership number and at least two of these fields match the database record. If a policy cannot be found, has lapsed or is invalid for that treatment, the bill is returned to the provider so the patient’s policy details can be checked.

Validated bills are forwarded to the insurer’s processing system, where they are far more likely to be passed and processed for payment first time by the insurer and not held while anomalies are investigated. This means consultants and providers are less likely to experience delays in the payment process.

Gary Dearnaley, Claims MI & EDI Manager at Bupa said: “This initiative is part of the work we are doing to improve our service to consultants and providers. Healthcode’s secure solution will help smooth out the small number of errors we encounter in the electronic billing process, which will benefit consultants, providers and Bupa members alike, we’re pleased to be the first insurer to offer this service.”

Intelligent Validation was developed by Healthcode as an enhancement to its existing online bill clearing service which currently processes over a quarter of a million bills each month. That already enables practitioners to securely submit bills online which include all the information necessary to be processed and paid in a fraction of the time of manual invoicing.

Liam Mannion, Group Revenue Manager at BMI Healthcare said the BMI hospital group are extremely positive about Healthcode’s new service, explaining: “We produce over 3,000 bills every day and it’s in our interests that we can identify and fix membership registration issues sooner which will benefit all parties involved. This service allows the patient information to be 100% correct before they reach the insurer and we are more likely to be reimbursed more efficiently”.

Healthcode’s Managing Director, Peter Connor commented: “Our e-billing technology already provides a more efficient and secure way for independent practitioners to invoice insurers than time-consuming paper systems. However, the additional tier of validation we have developed is even more sophisticated as it automatically checks and corrects errors which would normally mean that invoice is held up in the insurers’ systems. We are pleased that Bupa was so quick to see the potential of Intelligent Validation and we believe it will soon become a must-have for other insurers.”