| South Carolina BlueCross Uses Benefitfocus to Handle High Volume National Accounts |
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Charleston, SC — August 31, 2005 – When BlueCross BlueShield of South Carolina’s National Alliance needed to enroll its 600,000 members and ensure HIPAA compliance, they turned to Benefitfocus.com, Inc. And they weren't disappointed. Since National Alliance adopted the Benefitfocus® eExchange service in 2003, it has saved incalculable amounts of time, energy and, most importantly, money.
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And it's only getting better. Benefitfocus® eExchange is currently delivering two million National Alliance transactions a month, and a new upgrade is going to make the service even faster.
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“We will be offering new tools, including a web presence, as part of our service upgrade,” says John Smith, Director of Benefitfocus eExchange. “This tool will have a research component and a dashboard accessible for both clients and carriers. For instance, our customers will be able to see when files have been delivered and which records errored due to missing or incorrect data.”
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Benefitfocus® eExchange receives daily benefits enrollment and eligibility data from large employers in multiple formats. The proprietary engine then interprets and translates the data into the insurance carriers' mandated formats and sends it directly to the carriers' membership systems. A team of data exchange experts concurrently handles all communication and reporting between the carrier, the employer and any outside payroll vendors to provide seamless data transfer and integration for employers and carriers.
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Because of its extremely robust claims, customer service and membership system, BlueCross BlueShield of South Carolina (BlueCross), an independent licensee of the Blue Cross and Blue Shield Association, has excess capacity that enables it to process and administer claims for other large plans under a program called National Alliance. The program manages data for five partner Blue plans.
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“Thanks to eExchange, not only can National Alliance handle the volume, but we can do it more cost effectively than we could prior to implementing eExchange,” says Arch Martin, Manager of National Accounts for BlueCross. “eExchange gives us the ability to get up to speed with a new client’s eligibility and be fully implemented in two to six weeks.”
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Martin adds, “In less than four years, we have added 600,000-plus members. We administer our clients’ claims, handle the back-end reporting and customer service, and eExchange is instrumental in providing us with eligibility data we need to handle complex national accounts. It makes our National Alliance plans more competitive, which leads to increased growth.”
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The new Web-based portal will allow full visibility to both employer groups and carriers 24 hours a day, seven days a week to enhance the ongoing management of daily transmissions. Groups can go to on the Web to see if and when their files are processed and sent to the carrier. They can also find statistical analysis on the data they have sent to the carrier, as well as any exceptions found in their data.
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Carriers will be able to see all of their clients’ files that have been received and processed by eExchange and transferred to them. Carriers may also research the raw data their clients have submitted to Benefitfocus and compare it to the scrubbed data that Benefitfocus submitted to the carrier. Plans will also be able to see exceptions and reasons that Benefitfocus returned insufficient or incorrect data, and monitor the time and date of data file transfers. These features will save them time and give them a secure way of viewing their data.
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“Before eExchange, implementation for new groups used to be quite tedious and very time consuming for both the group and for us here at National Alliance,” says Neil Fletcher, manager of electronic enrollment, systems and ID cards for BlueCross. “Groups can come on board for testing, and we will have them live in as little as two weeks.”
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A real time web interface will also allow more streamlined troubleshooting and customer service. A one-stop-shop for all their data needs, National Alliance clients will be able to click on a support link to contact Benefitfocus in real time.
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Benefitfocus® eExchange rounds out Benefitfocus' suite of benefits administration products and services by offering a way for companies with existing HRIS systems or third-party payroll vendors to communicate effectively and efficiently with carriers without having to use multiple applications or hire additional IT staff. |
About Benefitfocus
Benefitfocus.com, Inc. (Benefitfocus) is the leading provider of software and services for benefit enrollment, electronic billing, and data exchange. Our products and services utilize state-of-the-art technology, yet are compatible with existing systems and databases. They replace paper-based and error-prone processes and allow our clients to receive accurate information more efficiently and economically.
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About BlueCross BlueShield of South Carolina
BlueCross BlueShield of South Carolina is the predominant insurance provider in the state of South Carolina insuring over 1.6 million in the state. They have established themselves as a leading developer of products and services. Additionally, BlueCross BlueShield of South Carolina, with its development of My Insurance Manager, is a national award winning organization in the use of and development of leading web technologies. They may be reached at their web site at www.SouthCarolinaBlues.com
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