Blue Shield of California presented their industry leading program, Partnership in Operational Excellence and Transparency (POET), at the October 2008 MedeAnalytics Connect Conference in Emeryville.

Blue Shield’s innovative program uses Mede’s platform to share claims payment performance with partner hospitals. The metrics include claim cycle time (from discharge to claim payment), submission method (paper versus electronic), denial volume, appeal volume and outcome and Blue Card claim volume.

Participating hospitals can log into MedeAnalytics to access their own claims and review improvement opportunities jointly with Blue Shield representatives. Blue Shield’s program offers providers real transparency into claim performance. The investment that Blue Shield has made is expected to bring value to both sides of a historically adversarial relationship and promote administrative efficiency in the area of reducing re-work, shortening cycle times and increasing first pass claim processing.

Blue Shield of California, is a MedeAnalytics user who implemented our analytics platform as part of their industry-leading Partnership in Operational Excellence and Transparency (POET) program. This innovative program was established by Blue Shield of California in an effort to improve a historically adversarial relationship and to promote administrative efficiencies.

The MedeAnalytics Platform allows Blue Shield of California to share claims payment performance with partner hospitals. Metrics include claim cycle time (from discharge to claim payment), submission method (paper versus electronic), denial volume, appeal volume and outcome and Blue Card claim volume.

Participating hospitals have the ability to log into a MedeAnalytics site and access their own claims and review improvement opportunities jointly with Blue Shield of California representatives. The program is providing groundbreaking transparency into claim performance, not readily available before. The value achieved will be mutual as relationships improve and re-work is reduced, cycle times are shortened and first pass claim processing increases.

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