Topics
More on Claims Processing

Medical Banking Project releases reports on ACOs, claims adjudication

The HIMSS Medical Banking Project G7 Roundtable, a specialized think-tank of healthcare stakeholders, has released two new reports on accountable care organizations and real time adjudication of healthcare claims.

"The Intersection Between Accountable Care Organizations & the Financial Network of the Future" explores the emergence of ACOs in healthcare and what impact this might have on the "Financial Network of the Future."

The second report, "Exploring the Odyssey of Real Time Adjudication of Healthcare Claims" examines the evolution of RTA today and defines HIMSS MBProject's potential role in moving the RTA dialogue forward. This paper follows on the foundation laid from the 2008 HIMSS white paper "Real Time Adjudication of Healthcare Claims," by the HIMSS Financial Systems Task Force.

"The G7 is a collaboration among all health stakeholders to create a cohesive information network around healthcare and information technology to help build the financial network of the future," said John Casillas, senior vice president, HIMSS Business-Centered Systems, who explained banks and hospitals currently interact but do not share a common language that could significantly improve operational efficiencies. "The G7 Roundtable meets three times each year analyzing improved healthcare delivery through proposed medical banking systems, which takes paper billing into a single electronic channel that could spawn a new generation of efficiency tools and consumer-centric product offerings, and other topics of vital interest." 

Recently, the World Bank formed a new collaboration with the HIMSS G7 effort to use the thought leadership platform to advance critical policy issues in developing countries and bring together parties around potential demonstration projects in medical banking. There are up to 20 exclusive sponsors of the HIMSS G7 thought leadership platform.

"We are pleased the World Bank has decided to use the HIMSS G7 thought leadership platform and look forward to advancing global health using medical banking principles," Casillas said. At the 9th National Medical Banking Institute, the World Bank convened a forum moderated by Alexander Preker, who helped to instigate dialogue around an agenda for HIMSS and the World Bank. Preker is head of the Health Industry Group and Investment Policy Analysis for the Investment Climate Department of the World Bank Group.

The next meeting of the G7 Roundtable will be held on April 11 at the Vanderbilt Center for Better Health in Nashville, Tenn., where participants will provide contributions to the HIMSS ICD-10 Playbook around strategy, education and financial sustainability pre- and post- ICD-10 implementation. The Playbook will house information from health plans, financial institutions and other healthcare stakeholders to help providers with their ICD-10 needs.