Mid-week Miscellany

  • Based on its recent Board of Director’s decision to support an individual mandate (also found in the Baucus plan) to address the uninsured problem, AHIP, the managed care trade association, today unveiled a reform proposal called the Campaign for an American Solution. I think that it’s a great idea that the trade association is getting out front on this issue.
  • About ten years ago, I saw a vendor demonstrate a swipe card that allowed a doctor to verify eligibility, check benefits, and then charge the patient (because it could also be a credit card). It was real Buck Rogers then, but according to AHIP, Highmark, a BCBS insurer in Pennsylvania, is rolling out a real time adjudication system that will allow a provider — via the internet — to estimate within seconds what the patient will pay, and if the test or procedure already has been done, it can submit the claim. CIGNA is not far behind.