Management Strategies

03:37 PM
Kathy Burger
Kathy Burger
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Electronic Medical Records and Claims Management: Perfect Together?

I usually am skeptical when the government proposes something it asserts will make my life better. However, when it comes to the recent enthusiasm for adoption of electronic medical records (EMRs), I might be persuaded.

I usually am skeptical when the government proposes something it asserts will make my life better. However, when it comes to the recent enthusiasm for adoption of electronic medical records (EMRs), I might be persuaded. I've had enough dealings with healthcare providers and insurance companies over the years to know that some form of an electronic medical record will make it easier for me to manage my health insurance claims -- not to mention, as an aging baby boomer, an unavoidably lengthening roster of doctors and other medical providers.

For now, my own equivalent of an EMR is a Microsoft Word file that I periodically update and print out -- resulting in a relatively current printed list of doctors and medications that my husband and I tuck into our wallets. New doctors, their staffs and pharmacists are always impressed with our organizational skills, but wouldn't it be more efficient, accurate and safer if this roster existed electronically with password access? And I happen to be the proverbial educated consumer -- what about individuals who aren't as savvy and prepared in their dealings with healthcare providers and insurers? What do they do to make sure that everyone gets the right information, and how do they assure their claims are processed quickly and correctly?

And even with all my preparation, I still often have to deal with mistakes (sometimes my own, sometimes the provider's, sometimes the insurer's) about coverage and treatment when it comes to filing a claim. An EMR wouldn't completely eliminate such hassles, but it surely would simplify the claims process -- not just for me, but for all the "partners" (doctors, carriers, etc.) that are part of the claims process.

Of course, change does not come without risks and there are many extremely valid privacy and process questions to be resolved before EMRs become commonplace. From a technology and strategy perspective, these are exactly the kinds of questions Insurance & Technology is addressing as part of our new integrated offering Connected Enterprise: Straight-Through Processing in Insurance. In addition to I&T's recent coverage of the industry's efforts to achieve a more streamlined, integrated claims process and our monthly special edition e-mail newsletter, you can delve into the topic of claims transformation at a free editorial Webcast on Wednesday, March 9, "Maximizing the Claims Process," featuring experts from ACORD, TowerGroup and CSC.

Kathy Burger
Editorial Director
Insurance & Technology

Katherine Burger is Editorial Director of Bank Systems & Technology and Insurance & Technology, members of UBM TechWeb's InformationWeek Financial Services. She assumed leadership of Bank Systems & Technology in 2003 and of Insurance & Technology in 1991. In addition to ... View Full Bio

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