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Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare settings,...
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Breaking down barriers to electronic claims settlement.

Lynn Carroll1

  • 1Payformance Health, Jacksonville, Fla, USA. lynn_carroll@payformance.com

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|December 23, 2008
PubMed
Summary
This summary is machine-generated.

Electronic claims settlement is becoming more practical and cost-effective due to technological advances. Secure databases, bank-independent transfers, and secure archives are overcoming past obstacles for payers and providers.

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Area of Science:

  • Healthcare administration
  • Health informatics
  • Financial technology

Background:

  • Transitioning payer and provider environments to electronic claims settlement has historically faced significant obstacles.
  • Previous attempts were hindered by issues related to security, infrastructure, and inter-operability.

Purpose of the Study:

  • To evaluate the current feasibility of electronic claims settlement in the healthcare industry.
  • To identify key technological advancements enabling practical and cost-effective electronic settlement.

Main Methods:

  • Analysis of technological advancements in secure databases.
  • Assessment of bank-independent electronic funds transfer (EFT) and electronic remittance advice (ERA) systems.
  • Evaluation of secure archival solutions for claims data.

Main Results:

  • Technological progress has made electronic settlement increasingly viable.
  • Secure databases and bank-independent EFT/ERA enhance practicality and cost-effectiveness.
  • Availability of secure archives addresses data integrity and long-term storage concerns.

Conclusions:

  • Electronic claims settlement is now attainable due to recent technological innovations.
  • The healthcare industry can benefit from cost savings and improved efficiency through electronic settlement.
  • Overcoming past obstacles is now possible, paving the way for widespread adoption.