Staff Writer
Service marketed to hospitals, physicians, providers
With federal reforms projected to add 30 million people to the health-care system, one local company stands to grow both physically and financially.
Availity, a joint venture between Humana and Blue Cross and Blue Shield of Florida in 2001, aims to improve efficiency on the health information exchange side of the industry by directly connecting doctors and hospitals to insurance providers via an online portal.
“We’re the network,” said Julie Klapstein, Availity’s founding CEO. “We’re able to provide a lot of information that saves both time and money.”
Availity’s portal allows hospitals to access complete patient information, in real time, with a few mouse clicks.
The portal is more of an office tool than a patient tool, with nearly all of the costs absorbed by health insurance providers who end up saving money on each transaction by doing it virtually instead of physically.
The portal means doctors no longer must call individual insurance companies to determine a patient’s eligibility, send and receive faxes or determine how prescriptions interact, among other information.
Hospitals and physicians use the service for free, with a small exception if they decide to use items like the credit card service Availity offers.
Currently, the portal service is used by 1,400 hospitals, 55,000 practicing offices and 160,000 doctors throughout 20 states. It processes more than 660 million transactions a year.
“We expand region by region,” said Klapstein. “Before we move to an area, we go into it and try to sign with the major (health insurance) providers and try to get more than 50 percent.”
Currently, the portal service is available in states that include Florida, Texas, New Mexico, Oklahoma and Illinois, with a recent concerted effort in the Midwest, said Klapstein. Several more states should be added within the next five years.
The Jacksonville office, in Southside, employs about 180 people and another 120 employees work in Dallas, but that should change soon.
“We’re growing a lot,” said Klapstein. She expects at least 10 percent growth as the service starts to spread, especially with federal dollars available to hospitals and physicians who go the paperless files and transactions route.
The health information network’s slogan is “Patients. Not paperwork.” That could be all the more relevant as more people enter the health-care system.
“As health care grows, efficiency will be key,” she said. “Doctors will want to save time and money on paperwork so they can spend more time seeing patients.”
The advent of the Internet has made the endeavor possible, though early on insurance companies were less willing to share information until consumers started demanding the services.
Klapstein said some consumers worry about the security of their personal information.
The information, she said, isn’t actually stored within Availity, though it does transfer through it.
In addition, some hospitals and physicians who are schooled in the past ways of conducting transactions are much tougher to bring on board than the younger physicians familiar with the latest technologies.
“The generational gap is going to change,” said Klapstein, “because it really does save time, money and potentially lives.”
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