Blue Shield of California Kick-Starts Real-Time Claims Payments with Pilot in Sacramento Area

OAKLAND, Oct. 23, 2019 /PRNewswire/ -- Blue Shield of California, in collaboration with OODA Health and Dignity Health, has launched a pilot in the Sacramento area aimed at creating a better, faster – and more real-time – medical claims payment system.  During the 12-month pilot, members and physicians will use a new, fully digital payment system that eliminates paperwork for members and reduces the time-consuming collections process for physicians. Blue Shield aims to achieve real-time claims for all members statewide by 2023.

"Lengthy claims processes and excessive paperwork have long been a pain point for insurance plans, our members, and physicians," said Jeff Semenchuk, chief innovation officer of Blue Shield of California. "The first claim has already been successfully processed and members have been engaged with their consolidated bills."

Currently, patients may receive bills days, or even weeks, after their medical appointments. Meanwhile, physicians and their staff spend valuable time chasing down payments. With this pilot, medical bills are provided to patients are able to get cost information closer to the time when care is provided – with the ultimate goal being much like paying a cashier at a retail store or settling a bill at the front desk of a hotel.

Benefits for Members
The key benefit for members is to provide more clear and concise billing information, as this pilot will consolidate the bill (for readability), reduce the amount of time between the service of care and the bill (more real-time) and allow members to choose when to pay their balance – immediately or in installments (for financial choice).

Benefits for Doctors
For doctors, being able to collect payments from patients at the time of service will reduce administrative time, enabling them to instead focus time on serving patients' medical needs. This will lead to less physician burnout over time, which is a growing concern for this profession.

The Power of Collaboration
"This pilot is the first of its kind for California," Semenchuk said. "With the help of OODA and Dignity, we have taken learnings from other pilots and industries to create a system that will streamline the industry and reduce the pain points around claims. We would not be able to tackle these types of research-based experiments and help an entire userbase of the system if it were not for our collaborators, so we are thrilled to team up with OODA Health and Dignity Health to test out how to fundamentally shift the healthcare system for all involved."

Blue Shield chose to align with OODA Health for their technology assistance and Dignity Health for their physician network. This Sacramento pilot builds on the success of a similar pilot by OODA and Dignity Health in Arizona, which launched in June 2019 and has already seen very promising initial results in creating a more seamless payment process.  

Seth Cohen, president and co-founder of OODA Health, stated: "We are excited to partner with Blue Shield of California on this transformative approach to the patient experience. This is the beginning of a journey together to realize our vision for real-time payments, and I am looking forward to launching this product as well as jointly introducing new innovation in the near future."

The pilot will be rolled out with physicians in the Dignity Health network in the Sacramento area. And since Dignity Health is the fifth largest health system in the nation and the largest hospital provider in California, they are a leader in locations where Blue Shield of California members live, work, play and pray.

This pilot is one of several innovations that Blue Shield of California has introduced this year as part of its Health Care Model of the Future initiative. Other recent innovations include e-transcriptions of medical visits through Apple Watches and startups Notable and Altais, free Lyft rides to transport members to receive medical care, virtual care from physicians following the wildfires in Paradise, and more.

About Blue Shield of California
Blue Shield of California strives to create a health care system worthy of its family and friends that is sustainably affordable. It is a not-for-profit, independent member of the Blue Cross Blue Shield Association with 4 million members, 6,800 employees and more than $20 billion in annual revenue. Founded in 1939 and headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare health care service plans in California. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have an impact on California communities.

For more news about Blue Shield of California, please visit news.blueshieldca.com.

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SOURCE Blue Shield of California

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