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Related Experiment Videos

Claims on the Internet. A progress report on EDI developments.

J Goedert

    Health Data Management
    |December 8, 1997
    PubMed
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    The healthcare industry is exploring internet-based claims processing, but security concerns hinder a full transition from traditional Electronic Data Interchange (EDI). Some organizations are planning to bypass clearinghouses for direct internet use.

    Area of Science:

    • Health Informatics
    • Healthcare Administration
    • Information Technology in Healthcare

    Background:

    • Healthcare organizations are considering the internet for claims processing.
    • Traditional Electronic Data Interchange (EDI) is the current standard for healthcare transactions.
    • Concerns regarding security and other issues impede the adoption of internet-based claims clearinghouses.

    Purpose of the Study:

    • To examine the current landscape of internet adoption for healthcare claims processing.
    • To understand the barriers preventing a shift from conventional EDI to internet-based systems.
    • To identify alternative strategies being considered by healthcare organizations.

    Main Methods:

    • Analysis of industry trends and discussions regarding internet use in healthcare claims.

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  • Review of concerns impacting the adoption of internet-based claims clearinghouses.
  • Observation of healthcare organizations' strategic planning for internet utilization.

    • Main Results:

    • A significant shift from conventional EDI to internet-based claims clearinghouses has not yet occurred.
    • Security concerns are a primary barrier to widespread internet adoption in claims processing.
    • Some healthcare organizations are developing strategies to use the internet directly, bypassing traditional clearinghouses.

    Conclusions:

    • The transition to internet-based healthcare claims processing faces significant security hurdles.
    • Despite challenges, some healthcare entities are proactively planning direct internet utilization.
    • The future of healthcare claims processing may involve a hybrid approach or direct provider-to-payer internet channels.