New Jersey announces multi-payer portal to connect doctors with insurers

By Mike Miliard
11:01 AM
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In a development that was compared for its convenience and usefulness to banks' establishment of ATM networks, NaviNet, the country's largest real-time healthcare communications network, announced Thursday it would partner with major health insurers in New Jersey to build a multi-payer portal as a "one-stop shop" for physicians to communicate directly with an array of health plans.

Developed in concert with two insurance trade groups – America’s Health Insurance Plans and the Blue Cross Blue Shield Association – NaviNet's Insurer Connect will offer providers easy communication with five of New Jersey's largest insurers: Aetna, AmeriHealth New Jersey, Cigna, Horizon Blue Cross Blue Shield of New Jersey, and United Healthcare.

"We absolutely believe that our coming together to use the NaviNet provider portal will be making better use of doctors' times and their staffs' times, will streamline services to our members and ultimately will improve quality and reduce costs," said Christy Bell, senior vice president of healthcare management for Horizon Blue Cross Blue Shield of New Jersey, on a conference call.

Doctors in New Jersey spend an average of $68,000 annually simply checking referrals and benefit eligibility, and ensuring their patients are enrolled in the correct plans, it was noted. Such expensive, "time-intensive, redundant administrative tasks add no value to the healthcare system, and [are of] no direct benefit to patients," said Sal Bernardo, MD, of the New Jersey Academy of Family Physicians, who uses the portal. "It's an "excessive amount of time on paperwork that could otherwise be spent on direct patient care."

Working to obviate that administrative burden of all those phone calls and faxes is the aim, said NaviNet president and CEO Brad Waugh. "We’ve seen positive feedback and results from the more than 50,000 New Jersey providers that already use NaviNet on behalf of 95 percent of the state’s commercially insured population, so we’re confident that this initiative will improve efficiencies as well as deliver a foundation for a comprehensive national health information exchange.”

"Over the years," noted Bell, "healthcare has become very complex, with inherent tensions built into the system, and that's eroded trust between the parties that really do need to work together. [There are] many different carriers doctors have to deal with, different coverages they have to deal with, and these different coverages may have different rules….  This collaboration will reduce that complexity and improve interactions and relationships."

“In order to ensure our patients receive the best possible care in a timely manner, family physicians are always eager to find a more uniform, efficient and cost effective manner in which to exchange patient information with health plans," said Stephen Nurkiewicz, MD, president, New Jersey Academy of Family Physicians. "In this current healthcare delivery system, family medicine and other primary care practices must make a significant investment in their front desk staff time managing these types of communications with multiple health plans in New Jersey.  We are hopeful that the NaviNet Web-based portal will provide a uniform means to interact with health plans and access a broad range of information for our patients from a single Web site in real time."