Health Information Technology (HIT)

There are real financial gains to be realized for acquiring and using electronic health records (EHRs) and other electronic tools. As seen in recent headlines, federal stimulus incentives will be offering physicians up to $44,000 over five years for the adoption of EHR and other electronic tools.

The Availity^®1 Health Information Network Eligibility and Benefits (E&B) transaction provides real-time benefit results such as coverage status, copay, deductible, coinsurance amounts, member data and some lower level benefits.

In order to offer greater flexibility in managing account permissions on the Availity^®1 Health Information Network, Availity is upgrading its security platform in a series of two phases that will be completed by January 2010.

Care Comparison, a new education tool from Blue Cross and Blue Shield of Florida, Inc. (BCBSF) for BlueOptions members, will help educate members on options to consider before seeking elective care. The tool provides broad cost ranges for approximately 40 common procedures performed in hospitals, (both inpatient and outpatient hospital services), ambulatory surgical centers and imaging centers.

Blue Cross and Blue Shield of Florida, Inc. began a pilot program on September 21, 2009 that provides member cost sharing information for some out-of-state members through CareCalc. CareCalc for BlueCard^® will provide some other Blue plan information to CareCalc and CareCalc Real-Time Claims Adjudication (RTCA) transactions.

The Claim Reconciliation Tool (CRT) is a web-based tool built by Blue Cross and Blue Shield of Florida, Inc. (BCBSF) to enable providers to view a summary of claims that have previously been paid, rejected or pended.