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Analysis

Blue Shield of California Launches Real-Time Claims Payment Pilot

By Jack O'Brien  
   October 23, 2019

The insurer is testing the pilot in Sacramento, as part of a collaboration with OODA Health and Dignity Health.

Blue Shield of California (BSC) is launching a real-time claims payment pilot in Sacramento with assistance from OODA Health and Dignity Health, according to an announcement Wednesday morning.

As part of the collaboration, patients will be issued consolidated medical bills closer to the time when care was provided and have the option to choose when they will pay their balance, either immediately or in installments.

Jeff Semenchuk, chief innovation officer at BSC, said the first claim through the pilot has already been processed.

"With the help of OODA and Dignity, we have taken learnings from other pilots and industries to create a system that will streamline the industry and reduce the pain points around claims," Semenchuk said in a statement.

The insurer's aim is to mirror the retail experience for healthcare in a way that will benefit both patients and physicians. 

Related: Point-of-Service Payment Pilot Will Give Patients 'Retail-Like Experience'

The pilot, which will last for one year, follows on the heels of a similar program in Arizona that was launched in June and is being overseen by OODA, a San Francisco-based startup, and Dignity, a San Francisco-based health system. 

In July, officials from both OODA and Dignity spoke to HealthLeaders about the pilot's results and plans to expand to two additional hospitals in Arizona by this fall. 

"Our initial goal has been to leverage OODA's technology and processes to create a positive experience for our patients by increasing collaboration with payers," Steve Scharmann, vice president of finance and revenue cycle management at Dignity Health, said. "Through initial conversations with patients, we are hearing positive reactions to the new payment processes. 

Related: Dignity Health, OODA Health Talk Payment Pilot Expansion

Last year, OODA cofounder Sophie Pinkard talked to HealthLeaders about the company's efforts to roll out a cloud-based claims payment model in the Oakland area, which was also supported by BSC and Dignity.

"We believe that reducing the time and money required to submit and pay claims will enable payers and providers to dedicate those resources to patient care instead," Pinkard said.

Related: Tech Startup OODA Working With Insurers Toward Real-Time Claims Payments

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


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