Traditional Medicare Benefit Information Soon To Be Available Online To Doctors And Hospitals Through Blue Cross Blue Shield Of Michigan Web Portal

New Enhancement Adds To One Of The Largest Health Information Interchanges In The Nation

May 9, 2008

DETROIT — Beginning this summer, Michigan physicians and hospitals will be able to go online to check eligibility and benefit information for people with Traditional Medicare coverage. It's made possible by Blue Cross Blue Shield of Michigan's health care electronic data interchange clearinghouse and Web portal, one of the largest in the nation.

Through BCBSM's single Web portal — called web-DENIS — doctors and hospitals already have secure access to benefit and eligibility information for individuals enrolled in BCBSM, Blue Care Network and Medicaid plans. The addition of Traditional Medicare information is another giant leap forward.

"Benefit information on the vast majority of insured lives in Michigan now will be available 24/7 to physicians and medical facilities, helping them determine eligibility for health care benefits," said Mary A. Smith, BCBSM vice president of health care delivery strategy. "So when these individuals enter a hospital emergency room or most doctors' offices or medical facilities, the information will be available to their care provider." 

The launch of the expanded service follows a successful pilot of the service started this past March by the Blues, and reinforces the company's commitment to supporting a statewide initiative by Gov. Jennifer Granholm, the Michigan Legislature and other public and private organizations to make Michigan a leader in health information exchange. The health information exchange initiative seeks to improve the quality and efficiency of health care delivery by minimizing redundant data collection, meeting national standards for information exchange, encouraging patient-centered care and promoting patient safety and quality.

"This launch is another step forward in our efforts to increase the scope of patient eligibility and benefit information that can be found in one place by doctors and hospitals," said Smith. "When we make it easier for medical professionals and facilities to interact with health benefit information, they can spend more time on caring for their patients." 

"We are on a mission to strengthen and expand our electronic services to simplify the administrative process for doctors and hospitals," said Joe Hohner, BCBSM senior vice president and chief information officer. "Doing so eases their administrative burden and reduces health care costs." 

The BCBSM electronic data clearinghouse is expected to process 270 million BCBSM, Medicare, Medicaid and other health insurance transactions in 2008, including eligibility and claims information. Web-DENIS is expected to process an additional 90 million inquiries or transactions.

Web-DENIS is used by more than 30,000 Michigan physicians and other health care professionals, all Michigan hospitals and medical facilities and medical billers. The system is used by nine out of 10 physician offices in the state.    

The move to include eligibility and benefit information for Traditional Medicare beneficiaries is another in a series of enhancements BCBSM has enacted over time to expand online access features for medical professionals and facilities. For example, in a past joint effort with the Michigan Department of Community Health, BCBSM provided physicians and hospitals with statewide access to Medicaid eligibility and benefit information online through web-DENIS. As a result of that effort, web-DENIS has grown over the past three years to handle 9.5 million Medicaid-related transactions annually.

About Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to more than 4.6 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. The company offers a broad variety of plans including: Traditional Blue Cross Blue Shield; Blue Preferred, Community Blue and Healthy Blue Incentives PPOs; Blue Care Network HMO; BCN Healthy Blue Living; Flexible Blue plans compatible with health savings accounts; Medicare Advantage; Part D Prescription Drug plans, and MyBlue products in the under-age-65 individual market. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. http://www.bcbsm.com