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Jopari Advises Claims Payers to Ready for e-Billing: Business

Jopari Solutions said at least three states have set timetables for implementing electronic medical billing in 2007, and it has a product ready for delivery.

In a press release Tuesday, Jopari said it can provide comprehensive “front-to-back compliance” for the payer, with little impact on the payer’s existing information technology systems. Jopari said capturing and standardizing all bill and pay data allows payers to seamlessly execute medical Electronic Data Interchange (EDI) state reporting.

“End-to-end electronic bill and prompt payment mandates are reshaping the jurisdictional landscape workers’ compensation payers must deal with,” said Jopari Chief Executive Officer Steve Stevens. “Fortunately, advancements in technology offer an immediate answer.”

Jopari said demand for standardized EDI processing capability has become an issue for insurer and third party administration claims operations in a growing number of state jurisdictions.

The International Association of Industrial Accident Boards and Commissions (IAIABC) is working to achieve national adoption of workers’ compensation EDI standards over the next several years, Jopari said.

California, Florida and Texas have already set timetables implementing mandatory e-billing and e-payment rules, including accelerated provider payment time frames in California and mandatory medical bill EDI reporting, Jopari said.

The legislative mandates are under California Labor Code Section 4603.4, Florida Administrative Code 69L-7.602/69L-56 and Texas Labor Code Section 408.0251.

In addition, numerous jurisdictions are actively considering legislation supporting industry conversion to universal American National Standards Institute (ANSI) X12 837/835 transaction standards for medical bill and payment processing.

Regulatory pressure to transition from conventional paper based bill and payment processing to standardized electronic transactions is spurring leading insurers and third party administrators to evaluate technology solutions that provide compliance and improved operational efficiency.

Jopari said a number of solutions providers are expected to enter the “jurisdictional compliance technology market,” while Jopari and similar companies are already delivering full back-end payment automation services to clients.

While implementation of e-bill and e-pay requirements in Texas is slated for January 2008, and targeted for early 2008 in California, many payers are moving now to put compliant solutions in place, the company said.

“Payers need to act quickly to evaluate available solutions and make go-forward decisions,” said Jopari Vice President Jim Grim. “Jopari is in negotiations with several large national carriers and TPAs who know that they need to move on this issue now. Waiting until Q3 of 2007 is not an option.”

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