| [October 26, 2004] |
 |
GTESS and ppoONE, a Unit of Fiserv Health, Strike Strategic Business Alliance
RICHARDSON, Texas --(Business Wire)-- Oct. 26, 2004 -- Expanded Connectivity, Advanced "Front-End" Claims Processing and Automated PPO Repricing Create the Most Efficient and Cost-Effective Claims Workflow Possible
GTESS Corporation, a leader in providing business process and automation outsourcing services to the healthcare payer and preferred provider organization (PPO) marketplace, announced a strategic business alliance with ppoONE. Together, GTESS and ppoONE, a wholly owned subsidiary of Fiserv Health, and a nationally recognized ASP provider of Internet repricing applications, will market a complete, front-end automated repricing service to the PPO marketplace, called PPO Connect Plus(TM). The companies also announced today the signing of an agreement with Southcare/Healthcare Preferred, a subsidiary of Coventry Health Care, for PPO Connect Plus(TM), currently under implementation.
"This relationship offers a unique, value-added offering that increases claims repricing efficiencies, expands electronic connectivity and greatly lowers PPO operating costs," said GTESS CEO & President Deborah M. Gage. "And, we're thrilled that Southcare, a leader in the rental PPO network market, recognizes the value in streamlining its repricing processes in this way."
PPO Connect Plus(TM)
PPO Connect Plus(TM) is a new outsourcing delivery model for the PPO marketplace that offers complete and streamlined PPO claims repricing services by combining GTESS' front-end services with ppoONE's repricing services, enhanced and coordinated with automated workflow technology. PPO Connect Plus(TM) includes the following services:
-- EDI claims intake from national clearinghouses
-- Complete mailroom services
-- Conversion of all types of paper claims to EDI
-- Guaranteed accuracy rate of 99%; guaranteed turnaround times
-- Automated provider matching and application of custom business rules to maximize auto-repricing
-- PPO data loading, cleaning and warehousing services
-- Access to electronic connections to other PPOs for primary, wrap network and fee negotiation partner access
-- Web-based network reporting
-- Automated claims routing, claims tracking and document management services, and
-- Standardized implementation and customer service processes
Additional Advantages
In addition to PPO Connect Plus(TM), both GTESS and ppoONE will offer expanded electronic connections to national and regional PPOs. Payers using GTESS' PPO Connect(TM) can now electronically access PPOs using ppoONE's application or they can load their PPO network data on the ppoONE platform for electronic repricing. Currently, the largest nationals and many regional PPOs are connected electronically by the GTESS/ppoONE partnership, and the companies anticipate that electronic connections with many more PPOs will occur before the end of 2005.
GTESS is a provider of business automation solutions for healthcare plans and benefit administrators. The Company leverages proprietary technology that replaces error-prone human processes with automated workflow in a superior service model to lower the cost and improve the quality of healthcare payment systems. Our services include a total front-end claims processing system of integrated, client-customized advanced technology for claims receipt; a suite of CleanClaim Technologies(TM), including verification, data quality improvement, duplicate claim detection, and member and provider verification; PPO-Connect(TM) network management and repricing services, claim routing and tracking, and document management. Our 'clean-claim' HIPAA-compliant electronic data interchange (EDI) delivery systems go beyond what can be achieved by automating parts of the process, or outsourcing operations off-shore. We deliver higher-quality data and cleaner claims, which result in dramatic improvements in turn-around times and processing costs. For more information, please visit www.GTESS.com or call John McGahey, GTESS VP of Sales and Account Management at 972-792-5512.
ppoONE, a Fiserv Health company, is a leading information services company providing enterprise business solutions for the health care industry. Based in Dallas, the company delivers dynamic products for niche health care segments. As an Applications Service Provider (ASP), ppoONE is a market leader for automated claims repricing, fee schedule maintenance, provider data management, credentialing, customer service, and reporting for PPOs, TPAs, managed care plans and insurance carriers nationwide. Call Diane Rodgers, ppoONE's VP of Sales and Account Management at 972-447-6480 or visit www.ppoone.com.
SouthCare/Healthcare Preferred offer insurance companies, third-party administrators and large self-funded companies expansive PPO provider networks in eleven Midwestern, Southeastern and Mid-Atlantic states. Covering over 550,000 members, SouthCare/Healthcare Preferred uses a flexible, local and customer-focused approach to service both payor and provider clients. For more information on Southcare/Healthcare Preferred, visit www.southcareppo.com or call Kevin Jerome, SouthCare's Director of Business Development at 678-202-2117.
[ Back To TMCnet.com's Homepage ]
|
TMCnet LOGIN
Webinars
