November 30, 2012 -- FamilyCare Inc., a non-profit health plan serving Medicaid and Medicare members and Salem-based Performance Health Technology (PH Tech) have joined forces to pay medical claims more quickly and accurately.
In July, FamilyCare began transitioning Medicaid claims processing to PH Tech, a company which specializes in processing claims for health plans. The Medicare claims transition is in process and is expected to be completed by January 1, 2013.
“FamilyCare is committed to our mission, ‘creating healthy individuals through innovative systems’,” says Jesse Gamez, Chief Operations Officer. “One of our goals this year was to improve the speed and accuracy of our claims processing to better serve the providers in our network and ultimately, our members.”
Claims Administration Manager Amy Bruce, of PH Tech’s Northern Region, says she is pleased to partner with FamilyCare. “We wanted to make this a smooth transition for FamilyCare and as seamless as possible to their providers.”
FamilyCare network providers were granted access to PH Tech’s secure web-based tool,
Clinical Integration Manager (CIM). All information regarding consultation referrals and others services are entered into CIM and allows providers to check eligibility and authorization status.
Also, they have a direct communication line to claims and authorization personnel via email. Beth Welty, program manager at Children’s Health Alliance, a provider of pediatric services for FamilyCare members, says she is pleased to see this improvement in claims processing.
“Using this technology for managing claims reduces the administrative time for providers,” says Welty, “More importantly, it gives providers better access to the patients referral and authorization information, which allows for easier and more comprehensive follow-up care.”
