Health Net 2000 Annual Report Download - page 13

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The administrative hassle of working with a health plan was taking away the pleasure of practicing medicine. He was spending
too much time on the phone dealing with administrative issues - time he could be spending with patients. Something had to
change. In August of , Dr. DoRosario called PHS Health Plans to voice his frustration. PHS suggested they work together
to develop a solution to the issues affecting his practice. In February of , PHS and PriMed launched an Internet-based program
to replace paper-based administrative tasks and phone calls.Today, the medical group checks eligibility and submits claims, authorizations
and referrals over a secure Web site, allowing for real-time transactions - and almost cutting in half the time doctors and their staffs
previously spent on these tasks.
Working Together - Through its partnerships with health care providers, technology companies and
other health plans, Health Net is working to improve and simplify processes for all of its stakeholders. In 2000, the company
and its subsidiaries introduced several initiatives designed to improve relationships with consumers and physicians.
CAQH In early 2000, Health Net joined the Coalition for Affordable Quality Healthcare (CAQH) - a coalition
representing 24 of the nation’s largest health plans. CAQH is committed to working with others in the medical
community to address issues where collective action will make life simpler and easier for consumers and their doctors.
Through several initiatives, CAQH is developing programs to improve access to quality health care coverage; work with
doctors to improve health care quality; and make administration and information easier for doctors and consumers.
Jay Gellert, chair of CAQH’s Administrative Simplification Committee, has committed Health Net to work closely with
CAQH to achieve these goals.
NaviNet In February, PHS Health Plans launched an Internet-based pilot project called NaviNet with the
Connecticut-based medical group PriMed to reduce the administrative burden experienced by physicians and medical staff.
Developed and owned by NaviMedix, Inc., NaviNet enables medical offices to expediently handle eligibility
inquiries, referrals, authorizations, claims and other administrative tasks via the Internet.
The results from this program are impressive: Medical offices are experiencing a 50 to 75 percent reduction in the
time spent resolving claims, processing referrals and verifying membership eligibility. Due to its success, PHS had rolled
out NaviNet to more than 3,500 Connecticut physicians by year-end.
MedUnite In addition to the NaviNet project, Health Net led the effort for the industry-sponsored provider
connectivity initiative called MedUnite.
During the early days of MedUnite, Health Net brought together health plans and some of the nation’s most
innovative and successful technology companies to develop an Internet-based connectivity solution to reduce transaction
costs and provide physicians with a standard, easy-to-use method for transacting business with health plans.
2000 Annual Report HEALTH NET 11