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Blue Shield of California expands payment collaboration with Dignity Health 

Getting paid has become imperative during a time when both hospitals and patients may be cash-strapped.

Susan Morse, Managing Editor

After a successful pilot, Blue Shield of California will roll out the Ooda payment platform to more than 20 additional Dignity Health hospitals throughout California.

The nonprofit health plan teamed up with CommonSpirit Health (which operates Dignity Health hospitals) and software startup OODA Health on the high-tech pilot program. The three organizations launched the "member payments" pilot in September 2019 at two Dignity Health hospitals in Sacramento. The year-long program grew to include six hospitals.

WHY THIS MATTERS

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As providers have struggled with cash flow issues because of COVID-19, Blue Shield said the Ooda platform can enable near real-time claims payment.

Blue Shield of California members who receive care at the Dignity facilities get a more transparent bill, options on how they pay for their portion and a more retail-like experience.

Initial results show the process makes cost share payments more streamlined, resulting in a 92% satisfaction rate from patients who used it.

HOW IT WORKS

Blue Shield of California members receive a consolidated monthly medical bill from Blue Shield. The patient can choose a payment method for the amount owed – in full or in interest-free installments through their Flexible Spending Account card, credit card, check or ACH direct deposit connection.

Participating healthcare providers receive help managing the financial responsibility, which improves their financial performance and reduces the time spent on paperwork and tracking down unpaid bills, Blue Shield of California said.

As part of the collaboration, the insurer also has implemented new technology to reduce manual processes.

THE LARGER TREND 

In the spring, the COVID-19 pandemic halted most elective medical procedures, the bread and butter of hospital revenue. 

Procedures have begun again and care has been augmented by new telehealth flexibilities, but collecting on unpaid bills has become problematic at a time when many Americans are suffering financially and may have lost their jobs as well as their employer health insurance coverage.

When New York City-based Northwell Health tried to collect, The New York Times ran a story that said the health system was suing more than 2,500 patients for unpaid medical bills averaging around $1,700.

Speaking to Healthcare Finance News, a hospital spokeswoman explained that at the start of the pandemic, from April to September, Northwell imposed a six-month-long pause on legal filings. The lawsuits referenced by The Times were from medical incidents before the COVID-19 pandemic, according to Barbara Osborn, Northwell's VP of public relations.

But probably due to the negative fallout from the story, Northwell put a pause on all legal filings and rescinded claims from 2020.

ON THE RECORD 

Seth Cohen, co-CEO and cofounder of OODA Health, said, "We are honored to grow this collaboration to help even more patients navigate their medical bills, especially during this turbulent time."

"Our goal is to make the medical billing process better so providers can focus on delivering care to patients that will improve their health and wellbeing," said Shayna Schulz, senior vice president of transformation and operations at Blue Shield of California.

"We want to support our patients through the entirety of their medical journey so they can focus on their healing. This collaboration with Blue Shield of California and OODA does just that by using technology to make patient medical bills easier to understand," said Steve Scharmann, VP of revenue cycle at CommonSpirit Health.

"An important part of caring for our patients is to ensure they have a seamless financial experience that is equal to the high-quality care they receive at our hospitals."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com