NAPERVILLE, Ill., June 3 /PRNewswire/ -- Health Network Systems, LLC (HNS) a network transaction management company and subsidiary of Concentra Preferred Systems Inc., a leading claims management company, announced that PacifiCare Health Systems Inc. , has implemented a new contract pricing technology developed by Health Network Systems allowing PacifiCare to automate the claims reimbursement function.
The implementation of Health Network Systems' pricing service has enabled PacifiCare to increase auto-pricing of its claims and improve its auto- adjudication rates and claim turnaround time.
"Our goal was to further utilize transaction-management technology to lower our general and administrative expenses and enhance our relationships with our contracted providers," said Ron Davis, PacifiCare's Senior Vice President and Chief Administrative Officer. "We selected Health Network Systems for its financial accuracy, its support of ongoing regulatory changes, and its ability to automatically link to its non-network business partner, Concentra Preferred Systems."
"Our pricing and provider identification systems were specifically designed to complement existing payor systems for greater ease of implementation, while also improving the quality and cost effectiveness of the claims reimbursement function," said Ben Slocum, Senior Vice President of Strategic Development for Health Network Systems. "We believe that our partnership will produce continued benefits for PacifiCare, its contracted providers and its members."
About PacifiCare Health Systems:
PacifiCare Health Systems is one of the nation's largest consumer health organizations with more than 3 million health plan members and approximately 9 million specialty plan members nationwide. PacifiCare offers individuals, employers and Medicare beneficiaries a variety of consumer-driven health care and life insurance products. Currently, more than 99 percent of PacifiCare's commercial health plan members are enrolled in plans that have received Excellent Accreditation by the National Committee for Quality Assurance (NCQA). PacifiCare's specialty operations include behavioral health, dental and vision, and complete pharmacy and medical management through its wholly owned subsidiary, Prescription Solutions. More information on PacifiCare Health Systems is available at http://www.pacificare.com/
About Health Network Systems
Health Network Systems, LLC (HNS) is a network transaction management company that helps payors, PPOs, HMOs and TPAs improve the quality and cost effectiveness of the claims reimbursement function. Leading payors rely on Health Network Systems for their expertise and technology to achieve improvements in network transaction performance. Health Network Systems addresses the need for accurate, consistent and timely claims payment through a powerful pricing application and provider database. These automated solutions are proven to significantly reduce administrative and medical costs, and improve provider and customer relations. Health Network Systems is a part of the Concentra Preferred Systems, Inc.(R) enterprise, a wholly owned subsidiary of Addison, Texas based Concentra, Inc.(R) All rights reserved. http://www.hnsconnect.com/
About Concentra Inc.
Concentra Inc. is the comprehensive outsourcing solution for containing healthcare and disability costs. Serving the occupational, auto and group healthcare markets, Concentra provides employers, insurers and payors with a variety of integrated healthcare services. These services include employment- related injury and occupational healthcare, in-network and out-of-network medical claims review and re-pricing, access to specialized preferred provider organizations, first notice of loss services, case management and other cost containment services. Concentra is a registered trademark of Concentra Operating Corporation. All rights reserved. http://www.concentra.com/
To receive HealthNetwork Systems (HNS) news releases by e-mail, contact axpeterson@concentra.com . Please include your name, affiliation and e-mail address. HNS news releases are also available on the HNS home page, http://www.hnsconnect.com/ .
Health Network Systems, LLCCONTACT: Amanda Peterson, +1-630-649-5237, or Axpeterson@concentra.com ,or Gene Della Torre, +1-630-649-5045, or Gdellatorre@concentra.com , both forHealth Network Systems, LLC
