Newspaper article The Florida Times Union

Hospitals Take over Claims Work

Newspaper article The Florida Times Union

Hospitals Take over Claims Work

Article excerpt

Baptist/St. Vincent's Health System officials have decided to

take over the claims processing for the 50,000 people served by

the hospital network's health plan.

The move furthers the health system's ambitious effort to

assume most of the functions of a traditional health insurer.

While Baptist/St. Vincent's officials say they have no

immediate intention to market their health plan to the public,

mastering claims processing would make it easier for them to do

so, if they later desire.

In early November, Baptist/St. Vincent's officials informed

Jacksonvillebased Employers Mutual Inc., the firm that now

processes the system's claims, that the health plan would start

doing this work itself next year, said Markus Mueller, the

processing company's chief executive.

Beverly Pascoe, the head of Baptist/St. Vincent's health plan,

called Mission:Health, downplayed the significance of the

decision.

"To me, it is not a new thing that we are going to be doing

claims," she said.

Mission:Health has already been overseeing Employers Mutual's

work, and the claims are processed using a computer system that

is already owned by Baptist, she said.

Baptist/St. Vincent's decided to move its claim processing

in-house because Mission:Health's business had grown to the

point that it became economical for the health plan to begin

doing this itself, she said.

A year ago, Mission:Health had but a few thousand members. Now

it will have about 50,000, she said. Mission:Health's business

comes from contracting to provide medical and managed care

services to health plans in the region.

Baptist/St. Vincent's began running help wanted advertising to

staff the its new claims processing unit this week, Pascoe said.

She declined to say how many people Mission:Health planned to

hire to do the work. …

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