Press Release
October 9, 2007
Health Cost Solutions Migrates To
Bloodhound’s Convergence Point
Southeast Third Party Administrator Utilizes Latest Claims Editing Solution to Improve Customer Service — All but Eliminating Physician Complaints
DURHAM, NC — April 13, 2009 — Bloodhound Technologies, the only claims editing and analytics provider offering a fully transparent, customizable, real-time service, announced that Health Cost Solutions (HCS), a Third Party Administrator (TPA) of group medical plans, has migrated from Bloodhound’s traditional claims editing application to its new ConVergence Point hosted service. HCS upgraded to ConVergence Point to improve customer service for all its constituents — from the plan administrators and the approximately 30,000 employees whose lives are covered by those plans to the physicians treating the employees.
“As a TPA, service is often the only thing you can provide to set yourself apart from the competition,” said Tawanda Travis, Vice President of Information Technology for HCS. “Our challenge is that we have multiple stakeholders with different needs to service. Clients want to control their healthcare costs, employees want the best coverage and care, and physicians want to be paid promptly and fairly. ConVergence Point allows us to use technology to improve our processes and service our stakeholders. Our clients get the best cost containment solution and our providers have full access to edit information, which reduces the number of provider inquiries and increases provider satisfaction.”
With Bloodhound, HCS has realized a drastic reduction in phone calls from physicians wanting to know why their claims were denied. Travis has processed more than 10,000 edits, and she can count on one hand the number of physician inquiries.
According to Travis, “A traditional explanation of benefits (EOB) is very limited in its description. When a claim is edited it is extremely important for the provider to understand exactly why their claim was denied so that they don’t automatically go back and bill the patient. ConVergence Point takes the provider to the physician portal on our Web site where they can see everything we’ve done to a claim, including the defense text, so that they can see exactly why the claim was denied.”
Travis anticipates continuing to improve HCS’ relationships with providers by giving them the ability to self-correct claims prior to submission via a Web services callout to ConVergence Point. This will let providers know whether their claim will be accepted before it is processed and enable them to make corrections at the very beginning of the claims process leading to faster payment for providers and a much smoother adjudication process for HCS.
“For TPAs like Health Cost Solutions, ConVergence Point eliminates conflict between payers and providers by delivering full transparency into the claims editing process,” said Gary Twigg, CEO of Bloodhound Technologies. “Patients are not back billed for claims that insurers have edited, and doctors are not calling to see why their claims have been denied. As a result, Health Cost Solutions is able to concentrate on differentiating itself from competitors by delivering an increasingly higher quality of service.”
Media Contacts:
David Jackson
Director, Marketing
Bloodhound Technologies
919.313.1651
djackson@bloodhoundinc.com
Christian T. Potts/Madeline Shedno
Schwartz Communications
781.684.0770
bloodhound@schwartz-pr.com