Firms to Offer Internet Processing System for P&C Medical Claims

Healtheon/WebMD, an Internet healthcare company, and HNC Software, a provider of predictive software, say they will offer property and casualty insurers and providers a way to process and manage medical claims via the Internet.

The partnership will enable payors and physicians to conduct medical transactions on the Internet, replacing the costly, traditional paper-based system. Companies can select the applications they want and pay on a per-click basis.

According to a survey from Milliman & Robertson, Seattle, and Coopers & Lybrand, Chicago, the cost of processing and paying a workers' compensation bill averages $15. By processing medical claims on the Internet, Healtheon/WebMD and HNC say the average cost could drop to less than $2 per bill.

``Healtheon/WebMD is pleased to be working with HNC to address this critical segment of the medical claims market on behalf of the payors and physicians who currently depend on a paper-based system to process the hundreds of millions of transactions that occur each year,'' said Mike Long, chairman and chief operating officer of Healtheon/WebMD.

The pair say the agreement gives HNC an exclusive arrangement to incorporate its predictive fraud and abuse detection system throughout Healtheon/WebMD's Internet services for Medicare, Medicaid and commercial health plan claims.

``The combination of HNC Insurance Solutions' core competencies in medical bill review for workers' compensation and auto claims, and Healtheon/WebMD's Internet connectivity, will transform claims management in the $291 billion property and casualty industry,'' said John Mutch, president and CEO, HNC Software Inc.

The first applications are expected to be integrated into the Healtheon/WebMD offering by mid-summer 2000, and will be expanded to include bill review, PPO repricing, utilization review and case management triage.