Carolinas Health System Cuts Costs With Online Billing

Client: Carolinas HealthCare System

Challenge: Reduce costs associated with transactions of patient eligibility and benefit verification information.

Solution: CSC DirectConnect, a flexible open-source system that uses the Internet to connect providers and payers directly with no transaction fees.

Results: An estimated $300,000 in annual savings, improved data architecture flexibility, a more controllable user interface and easier expansion to new or alternate carriers.

Learn more about CSC DirectConnect or our Health Services capabilities.

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As fast as technological advances revolutionize the practice of modern medicine, the latest IT solutions are also enhancing behind-the-scenes processes for major U.S. healthcare systems.

Verifying patients’ insurance eligibility is one example of a task that is often inefficient for many medical providers. While the eligibility checks are essential to reveal a variety of health plan specifics, to do them electronically often requires a costly transaction fee-based process which includes billing and follow-ups.

CSC’s DirectConnect allows many of our healthcare clients to transmit millions of transactions and billions of dollars worth of claims at much lower costs than traditional clearinghouses or payer portals. The solution recently went live at Carolinas HealthCare System (CHS), the largest healthcare system in the Carolinas, and the third largest public system in the nation.

Cut costs, not care

CHS viewed DirectConnect’s open-source, Internet-based delivery model as the best solution to reduce a costly fee-based transaction process for their operations, comprising over 4,900 licensed beds and supporting more than 800 physicians.

DirectConnect gives users the flexibility to control how they communicate with insurance carriers in real time. The revenue cycle-enabling solution is not only cost effective, but also simplifies transactions compared to CHS’ old model.

“It is a significant financial benefit to our organization and will become more significant as we add other providers to the network,” says Jim Burke, IT director at CHS, who estimates an annual savings of $300,000. “Besides cost savings, we now have more flexibility in data architecture, more direct control over the interface and easier expansion to new or alternate carriers.”

Leveraging a decade of experience

Our work with the New England Healthcare EDI Network (NEHEN), a multi-entity collaborative of payers and providers in Massachusetts, broke the mold and forms the core for this solution.

While much of the same infrastructure was used, the CHS implementation shows the value of DirectConnect for even single organizations as well, says Laurance Stuntz, who leads DirectConnect for CSC.

Over the past 10 years, other clients reusing the software and our vast healthcare revenue cycle process and EDI implementation expertise include Partners Healthcare, Blue Cross/Blue Shield of Massachusetts, Children's Hospital in Boston, Boston Medical Center, Tufts-New England Medical Center and NYU Medical Center.