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Web-based Self Service May Be Next-Best Thing

Tools permit access to prescriptions and claims and can simplify back-end processes.

Thanks to online enrollment, Brockton Hospital benefits representative Cheryl Willis can get a new employee confirmed for health-care coverage in less than 24 hours, a big difference from the week or more it took in the past to complete and mail paperwork to its managed-care organization, Harvard Pilgrim Health Care Inc.

Converts like Willis, who's been using Harvard Pilgrim's online services since the summer, have made Web-based self services a fast-growing channel for managed-care organizations to work with patients, employers, and doctors.

Managing Care Via The Web

  • 67% of managed-care providers let patients track claims online

  • 55% have online benefit explanations

  • 44% offer online prescription ordering

  • 8% is the average monthly growth in site traffic

  • Data: Cap Gemini Ernst & Young survey of 100 managed-care providers

    A semiannual study that Cap Gemini Ernst & Young conducted in October and released this month of about 100 managed-care groups shows that two-thirds let patients track their claims online. That's up from 59% six months ago and 27% a year ago.

    The fastest-growing Web-based service is prescription-drug ordering: 44% offer the service, up from only 14% in March. More than half offer online explanations of benefits, and more than one-third let patients change physicians online.

    Users of Web-based self services save time, paperwork, and calls to customer-service representatives. Health-plan providers benefit through lower call-center costs and happier customers. Providers also are starting to use Web tools to simplify back-end processes.

    Harvard Pilgrim is finalizing its rollout of a Web-based invoicing system from edocs Inc. Benefit administrators will be able to examine bills online and correct mistakes, which will mean more accurate bills. "This reduces the retroactivity we need to do," CIO Deborah Norton says.

    There's still room for progress. Willis notes that Brockton Hospital hasn't set up its business process to handle online billing yet.

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