CHAPEL HILL, N.C. —Blue Cross and Blue Shield of North Carolina (BCBSNC) has expanded its “on-site service model” to a fourth location: Duke University Health System. The on-site service model puts BCBSNC professionals on location in physician and hospital billing departments, where they work side-by-side with staff in those organizations to address questions and claims inquiries more rapidly and efficiently. BCBSNC also operates on-site service models at WakeMed, UNC Hospitals and UNC Physicians and Associates.
“The on-site model has provided opportunities to increase efficiencies and reduce waste. As a result, we have seen improved satisfaction among our customers and the physicians and hospitals with whom we work.” said Ian Gordon, senior vice president for commercial and government operations for BCBSNC. “Working side-by-side has improved communication between BCBSNC and health care providers, and allowed us to learn from each other as we continue on our respective paths of process improvement.”
BCBSNC’s on-site service model promotes open communication between health care providers and hospitals. Having BCBSNC representatives on site gives them the opportunity to address claims issues in a more streamlined and rapid manner, saving money for both organizations and providing a better experience for patients.
“Given the number of patients with Blue Cross Blue Shield of North Carolina insurance who come to Duke University Health System facilities and physicians, we think this will be a great way of improving service and making the claims inquiry process quicker and more efficient," said Scott Williams, administrative director of billing, collections and customer service at the Duke Health System. "We're excited that our on-site service model will benefit from the previous implementation experiences at three other sites.”
BCBSNC implemented the on-site service model as the first of its kind in 2009 at WakeMed in Raleigh and has also expanded to UNC Hospitals and UNC Physicians and Associates in Chapel Hill. Within a year of implementing the on-site model at WakeMed, more than half of all BCBSNC claims inquiries are resolved on the first day they are received, a 23 percent improvement from the previous year. The system also allows for further innovation, as many of the complex and secondary paper claims have been replaced by faster, more efficient electronic claims.
At UNC Hospitals, 55 percent of all inquiries are resolved upon initial contact and 63 percent within two days. UNC Physicians and Associates implemented the on-site model in September 2010, and they currently address 37 percent of all inquiries upon initial contact and 46 percent within two days.
BCBSNC plans to continue expanding the on-site service model.
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. For 77 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at bcbsnc.com.