Harvard Pilgrim Health Care, a major not-for-profit payer in New England, announced last week that it has entered into an agreement with transaction processor ProxyMed to offer physicians and hospitals free electronic claims and other transactions specified by the Health Insurance Portability and Accountability Act of 1996.
The insurer said the ProxyMed link was a result of both organizations' participation in the New England Healthcare EDI Network (NEHEN), a connectivity project involving 21 competing healthcare providers and payers in the Northeast plus three technology affiliates. ProxyMed, one of those affiliates, said it is the first clearinghouse to offer NEHEN members the opportunity to break with the traditional pay-per-transaction business model for claims submission.
ProxyMed said it would work with Harvard Pilgrim to give healthcare providers free access to four other HIPAA-defined transactions in 2004. The company also intends to help medical practices and hospitals in the Harvard Pilgrim network scrap paper-based billing in favor of electronic claims submission.
Harvard Pilgrim has about 800,000 enrollees in Maine, Massachusetts and New Hampshire.