News and Analysis

Blue Defend of California and Google Cloud introduced this week that they’re collaborating to launch a brand new strategy to paying suppliers, geared toward processing members’ claims in actual time.  

The businesses say they are going to use automated processing, synthetic intelligence and machine studying software program on a cloud platform to digitize healthcare claims and enhance the accuracy and timeliness of billing info.  

“Our collaboration leverages one of the best of each corporations – Blue Defend of California’s deep healthcare expertise and dedication to enhancing the well being of its communities and Google Cloud’s capability to develop and automate scalable know-how,” stated Aashima Gupta, director of World Healthcare Options at Google Cloud, in a press release.  

WHY IT MATTERS  

The well being claims cost course of in its present incarnation can take days – leaving suppliers questioning once they’ll be paid for companies, and members questioning how a lot their medical care will value.  

The collaboration goals to offer instantaneous info on out-of-pocket prices and Blue Defend funds, whereas addressing present spending on administrative complexity.   

“This plan to offer clear, concise and proper medical billing info will result in the creation of a nationwide mannequin to make all healthcare billing instantaneous and comprehensible, eradicating friction factors for customers and suppliers,” stated Gupta.  

Blue Defend says it can standardize its datasets and scale its ongoing automated billing efforts by integrating Google Cloud applied sciences and people from the medical health insurance firm’s different tech companions.  

Over time, Blue Defend plans to broaden the initiative to all suppliers, plan sorts and classes of claims processed, in addition to to well being info exchanges.  

“The purpose is to simplify the billing and cost course of for suppliers to allow them to spend extra of their time on affected person care,” stated Lisa Davis, senior vp and chief info officer at Blue Defend of California, in a press release.    

THE LARGER TREND  

Main payers have turned to well being IT innovators to attempt to streamline the claims course of over the previous few years, with an eye fixed towards selling transparency and chopping down on prices.  

As an illustration, the Blue Cross and Blue Defend Affiliation licensee Well being Care Service Company introduced in June 2020 that it’s working with digital well being report vendor Epic to construct a bidirectional change platform to attach payers with suppliers.  

The 12 months earlier than, Epic competitor Cerner partnered with affected person monetary expertise firm Simplee to supply customers a extra clear and customized healthcare billing course of.  

ON THE RECORD

“We’re reimagining healthcare by offering instantaneous billing info that’s digital, customized, clear and straightforward to know,” stated Davis.

Kat Jercich is senior editor of Healthcare IT Information.
Twitter: @kjercich
E mail: kjercich@himss.org
Healthcare IT Information is a HIMSS Media publication.