Irish healthcare industry introduces eClaims to promote faster submission of claims and faster payment

Electronic claiming has been successfully introduced for the first time in two key private healthcare providers in Ireland, it was announced today. eClaims will revolutionise the way claims are processed in the Irish healthcare industry. It is a joint initiative spearheaded by three of the key health insurers, Aviva Health, laya healthcare and Vhi Healthcare and is being co-ordinated by Insurance Ireland.

eClaims is well established worldwide in countries such as the United States, Australia and the UK. The aim of the initiative has been to rollout a national standard for electronic claims, which will benefit all parties, achieving savings through the reduction of paper work and providing healthcare providers with improved cashflow and resources to focus on patient care. eClaims will ultimately mean faster submission of claims and faster payment and will enable greater control of the claims management processes.

Last year, two private healthcare pilots were successfully completed and over recent months both have been submitting live electronic claims to the three health insurers for processing:

• Euromedic Ireland, a leading provider of diagnostic healthcare, supported by service provider Medserv; and

• UPMC Beacon Hospital, a Full Service Hospital, successfully went live with the SoftCo Claims Management Solution that supports the new eClaims Standard. UPMC Beacon Hospital have led the way by delivering the first eClaims solution in a Full Service Hospital. The SoftCo eClaims solution in UPMC Beacon Hospital is also integrated with the service providers, Hospital Accounting Services and Medserv.

Commenting on the introduction of eClaims, Michael Horan, Insurance Ireland said: “As the Irish healthcare industry looks to the future, eClaims will be a key driver of change across the sector.  All parties recognise the need to phase out the current inefficient paper claims process in favour of electronic processing. International best practice demonstrates that eClaims is the way forward, and it is imperative that the Irish healthcare industry develops its processes in line with these standards. I am delighted to see all parties coming together to bring this initiative to market and this demonstrates real success by the private healthcare providers in Ireland”.

Michael Horan added ”The success of the pilot in the private health sector, which is expected to be followed by a rapid adoption by other private hospitals, should serve as a model for the public sector to follow and help address the delays in submission of claims by the hospitals to the insurers. eClaims will also be a critical enabler for the Universal Health Insurance, where all healthcare facilities will be required to process a much higher volume of claims. This simply cannot be achieved with the current paper process.  The three main Healthcare Insurers are now focusing on the rollout of eClaims across the Irish Healthcare market, with the aim of making the current paper-based scanning submission process a thing of the past”.

The success of the eClaims pilot should serve as an impetus to both the Public and Private sectors to engage with this industry initiative and provide appropriate resources and leadership to implement the system. The Insurers have the resources and capacity to engage with any public or private hospital who are interested in pursuing the electronic claims process. Further information on eClaims is available on www.ehealthclaims.ie.