Bureau/Division/Agency

Legislature; Office of Policy and Legal Analysis

Document Type

Text

Exact Creation Date

1-1998

Description

The Task Force to Study the Feasibility of a Single Claims Processing System for 3rd-party Payors of Health Care Benefits was established by Resolve 1997, chapter 63. The Task Force was charged with both exploring the feasibility of a single claims processing system for third-party payors of health care benefits and the feasibility of streamlining the current claims processing systems used by payors.

The Task Force included legislators and members representing the interests of the Bureau of Insurance, the Department of Human Services, physicians, pharmacists, community mental health providers, home health care providers, hospitals, nonprofit hospital and medical service organizations, commercial insurers and employers.

The duties of the Task Force were to:

  • gather and examine information from other jurisdictions that have implemented a single claims processing system or have implemented a streamlined claims processing system;
  • identify barriers and problems that need to be addressed to implement a single claims processing system or to streamline the current claims processing system;
  • determine resources necessary to implement a single claims processing system or a streamlined system and develop a model for a single claims processing system;
  • determine the impact on health care providers and health insurance carriers in a single claims processing system or a streamlined system; and
  • identify the necessary steps for protecting the confidentiality of medical records and proprietary information in a single claims processing system or a streamlined system.


In its work, the Task Force addressed the structure of the current system and the problems faced by health care providers and payors. It also addressed the ongoing efforts to streamline and simplify health care transactions, including claims processing, at the federal level, in other states and in Maine.

Language

English

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Rights Statement

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