NAPERVILLE, Ill., June 24 /PRNewswire/ -- Health Net, Inc. has selected Health Network Systems, LLC, a subsidiary of industry-leading claims management company Concentra Preferred Systems, Inc., to provide contract automation and claim pricing services for its California and Oregon members. These innovative automated solutions will expand Health Net’s opportunities to increase claims auto-pricing and auto-adjudication rates.
Health Network Systems’ provider identification and pricing processes connect providers to the correct network contract and reimbursement rate. More than 95 percent of claims from providers who are part of the new system are expected to be auto-priced. This will allow Health Net to streamline claim pricing and data maintenance, decrease human intervention and utilize the information provided by the Health Network Systems provider and pricing system in contract negotiations and provider relations, all of which may directly impact its financial performance.
“Health Network Systems’ automated technology offers Health Net an auto- pricing capability that will help to reduce administrative costs, maximize efficiencies and allow us to streamline the claims adjudication process,” said Patrick Ross, Health Plans Officer-West for Health Net.
“We are excited for the opportunity to work with Health Net and are committed to delivering quality services as well as strategic and innovative solutions. We believe Health Net’s customers and members will realize the added value through accurate claim pricing,” said Ben Slocum, Senior Vice President of Strategic Development for Health Network Systems.
About Health Net
Health Net, Inc. is among the nation’s largest publicly traded managed health care companies. Its mission is to help people be healthy, secure and comfortable. The company’s HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to approximately 5.3 million individuals in 14 states through group, individual, Medicare, Medicaid and TRICARE programs. Health Net’s subsidiaries also offer managed health care products related to behavioral health and prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.
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 its expertise and technology to achieve improvements in network transaction performance. HNS 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 division of the Concentra Preferred Systems, Inc. enterprise, a wholly owned subsidiary of Addison, Texas based Concentra Inc. 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 Health Network Systems (HNS) news releases by e-mail, send a message to axpeterson@concentra.com . Include your name, affiliation and e-mail address. HNS news releases are also available on the HNS home page, http://www.hnsconnect.com/
Concentra is a registered trademark of Concentra Operating Corporation.
Health Network Systems, LLC
CONTACT: Amanda Peterson of Health Network Systems, LLC,+1-630-649-5237, or Axpeterson@concentra.com