關(guān)鍵詞： Navicure 資料交換中心 Version 5010 standards
2012年12月29日訊 /生物谷BIOON/ --在美國，資料交換中心充當(dāng)著醫(yī)務(wù)人員和第三方支付人員的中介,。2012年美國出臺了規(guī)范電子索賠的新標(biāo)準(zhǔn)Version 5010 standards,，許多資料交換中心的生存遇到挑戰(zhàn)。
根據(jù)調(diào)查公司KLAS針對資料交換中心的調(diào)查,，符合新標(biāo)準(zhǔn)并且顧客投訴率最小的是Navicure公司,，該公司的投訴率僅為4%。
資料交換中心的工作不僅僅是為客戶投遞索賠申請,，還包括在申請之前為顧客查出可能會影響索賠的瑕疵,，并盡快做出補(bǔ)救措施。
在2014年出臺的新規(guī)ICD-10（ the International Classification of Diseases）對整個索賠過程提出了新的要求,，屆時所有的資料交換中心將面臨著新的挑戰(zhàn),。(生物谷Bioon.com)
詳細(xì)英文報道：
Clearinghouses are the middlemen who route insurance claims from medical practices to third-party payers. Physicians do not give them much thought until it takes 4 or 5 months to get paid. Then they often point angry fingers at their middleman.
For proof, consider the transition this year to the new Version 5010 standards for electronic claims. Some clearinghouses struggled to get up to speed, with as many as 1 in 3 clients blaming their vendor for payment delays related to Version 5010, according to a recent study by research firm KLAS. Other clearinghouses kept this gripe below the 15% mark, which helped explain why they led the pack in the KLAS 2012 year-end ratings of these companies.
The winner of the clearinghouse sweepstakes is Navicure, with only 9% of its clients reporting Version 5010 claim snafus. The company's overall performance score of 92.9% reflects customer satisfaction with troubleshooting, communication, promises kept, and the like. Closely trailing Navicure are Office Ally (92.7%) and ZirMed (91.2%), which had a Version 5010 complaint rate of only 4%, according to KLAS. Bringing up the rear among full-fledged clearinghouses are Allscripts (77.5%), OptumInsight (78.5%), and Emdeon (79.1%).
Clearinghouses do more than just deliver claims to third-party payers like a mail carrier. They check a patient's insurance eligibility, catch errors and get them corrected before forwarding a claim, keep clients apprised of the claim's status, and analyze rejections so practices can learn from their mistakes. Good execution of these tasks translates into fewer denied claims and shorter days in accounts receivable.
Physicians will need crackerjack clearinghouses when they face the next big change in claims processing - the switch in 2014 to the new and controversial set of diagnostic codes called ICD-10, which stands for the International Classification of Diseases, Tenth Revision. KLAS found that most healthcare providers feel confident about the ability of their clearinghouse to adapt to ICD-10 codes if they handled the Version 5010 standards reasonably well. The clearinghouse inspiring the most confidence about ICD-10 is ZirMed (88%), with Navicure (82%) not far behind in second place.
The KLAS study, titled "Clearinghouse Services 2012: Yesterday 5010; Tomorrow ICD-10," can be purchased on the company's Web site. Survey data on individual vendors are free if physicians complete an online survey about the medical software, equipment, or computer services they use.
(責(zé)任編輯：zengchang)
