Articles & News About Health

Health Cost Solutions Integrates with Bloodhound Technologies for Pre-Adjudication Clinical Editing

Raleigh, NC and Hendersonville, TN (PRWEB) November 8, 2007 -- Health Cost Solutions (HCS), a leading TPA for self-funded group medical plans, today announced a groundbreaking integration with Bloodhound Technologies that will allow HCS to edit claims pre-adjudication while giving complete edit information back to providers.

Health Cost Solutions prides itself on providing unsurpassed service to customers by focusing on personalized service and driving a reduction in health care costs. One of Health Cost Solutions' strategies for containing costs is to use technology and process improvements to affect behavioral changes in all stakeholders. HCS uses Bloodhound to help facilitate those changes by giving providers full access to edit information in an effort to reduce the number of provider disputes.

"One of our concerns, and I hear this from other TPAs, is that providers will not accept edits that cannot be easily backed up with documentation which could lead to the employees of our self-funded plans being balanced billed," said Tawanda Travis, Vice President of Health Cost Solutions, "Our challenge as a TPA is to both reduce our client's healthcare costs and keep their employees happy. By using Bloodhound we can apply sound, fact based edits to claims and supply providers, via our website, with detailed edit information which helps us accomplish both goals."

Since going-live with Bloodhound's editing solution HCS has seen a significant reduction in plan cost and member cost by applying proper edits and educating the provider community. The provider community has embraced viewing edit information online and is using the information to improve billing practices. "We have been in production for several months and have had very few provider calls questioning the edits. Once we steer them to the website so they can see the defense text and defense author and walk them through the process they have no dispute. We have had more than one provider billing office apologize for their error and advised us that they would send a corrected bill and bill properly in the future," said Travis. HCS teamed up with Bloodhound Technology, Coalition America and Healthx to bring this complete package to its clients and the provider community.

"We are thrilled to be working with HCS and are very impressed with their strategic thinking," said Gary Twigg, President and Chief Executive Officer of Bloodhound. "HCS really shares our vision and is the first TPA in the country to embrace this strategic shift in the way claims are edited and processed. This integration really differentiates them in the marketplace."

About Health Cost Solutions

Health Cost Solutions is a growing leader in the TPA arena of self-funded group medical plans by aggressively serving their clients beyond the limits of the competition. HCS operates as an extension of the client's staff, empowering them to achieve and exceed the financial and benefit objectives established for their company's health plans. HCS aligns itself with best of breed partners to offer services that will contain and reduce total plan cost in ways beyond typical discount savings. The effects of HCS' philosophy is evident in their client retention rate that far surpasses the industry average.

About Bloodhound Technologies

Bloodhound Technologies provides claims editing and business analytics services to all participants in the claims revenue cycle. Bloodhound's claims editing service can process a claim against 16 million edits across total patient history in sub-second response time. All our edits are open-sourced and based on national standards and can be filtered to exactly match a payer's re-imbursement policies. Further, we provide a web portal for providers to see edits and correct claims before submission. This remarkable service can integrate with any claims adjudication system, clearinghouse, or claims gateway.

Media Contacts:

Health Cost Solutions

Bill Beeler

Chief Executive Officer

1.800.526.3919

Bloodhound Technologies

David Jackson

Director of Marketing

1.866.807.3098

djackson(at)bloodhoundinc.com

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