The impact of the attachment implementation in the healthcaredomain
Journal Title: IOSR Journals (IOSR Journal of Computer Engineering) - Year 2014, Vol 16, Issue 6
Abstract
Abstract: An “attachment” is any supplemental health documentation needed from a provider to support aspecific business process in the Healthcare domain while using electronic exchange within the organization orbetween healthcare companies and payer and/or providers. The purpose of this study is to enhance thesubmission of the healthcare transactions by adding an attachment for each transaction. This study includes thesubmission of medical documentation to support; that includes Health care claims, Appeals, Preauthorizationsfor services, Referral authorizations, Enrollee eligibility inquiries and Coordination of benefits.An attachment can be ‘solicited’ via a request from the provider or ‘unsolicited’ (sent pro-actively by theprovider and not tied to a health plan request.) The majority of Attachments are solicited vs. unsolicited. We can notice a high difference between the ones are for and the ones against by comparing 70% and 30% whichclarifies how this implementation will make the companies achieve a better and effective exchange of info whichcan improve the quality of the services.Our study showed also that between 5-20% of claims submissions require attachment information and that 30 to 45% of healthcare companies were able to feel an improvement in the transactions between the payer and theprovider. And also 45-55% of users welcomed the upgrade of the new change by adding an attachment to thetransactions.Implementation of the attachment as a new functionality was able to facilitate the exchange of information andeffective communication between parties.
Authors and Affiliations
Hicham Amine , Abdelouahab Mesnaoui , Safaa Elkhaddam
Keywords
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