Working Electronically With Aetna Can Give Doctors And Hospitals More Time With Patients And Help Them Reduce Costs

HARTFORD, Conn., March 04, 2009 — In these challenging economic times, using Aetna's online tools for billing and administrative tasks can help doctors and hospitals save time and up to $20 per patient visit. At a time when every penny counts, health care practices could be adding thousands of dollars annually - or even monthly - to their bottom lines.

"Conducting business with Aetna electronically can help health care providers decrease the time spent on non-clinical paperwork, increase the timeliness of cash flow into the office, and free up time for physicians to do what they do best -- care for patients," says Paul Marchetti, head of Aetna National Networks and Contracting Services. "We understand that health care providers are running businesses as well as delivering care, and we want our participating physicians and health care professionals to be successful at both."

Every transaction counts
Each electronic transaction has an associated financial savings when compared to using paper or making a phone call. Using 2008 Aetna claims volume data from physicians and hospitals in 15 markets, Aetna estimated the savings potential if electronic transactions were used for eligibility and benefits inquiry, claim submission, claim status inquiry, electronic remittance arrangements/electronic funds transfer (ERA/EFT) and precertification. Results showed that on average providers could save $1,200 to more than $200,000 annually, depending on claims volume, by using electronic tools. 

Aetna used its new EDI Savings Calculator to calculate these potential savings. The electronic transactions savings potential calculator is now available on aetna.com. The calculator gives physicians or office staff the option to input their actual costs including labor, monthly Internet expense, and patient and paper volume, or they can use estimates of labor and other costs based on data from the 2006 Milliman report, "Electronic Transaction Savings Opportunities for Physician Practices," sponsored by Emdeon.

The versatility of the calculator helps solo practices estimate savings based on their specific patient activity while also giving large hospitals or provider groups a quick and easy way to see their savings potential based on their larger claim volumes using the Milliman estimates. (The Aetna estimates above were calculated using the Milliman estimates. For a copy of the Milliman report, visit http://www.ushealthcareindex.com/resources/Milliman_EDI_Benefits.pdf. The calculator will be updated as new information becomes available in upcoming reports.)

The following chart illustrates the savings per transaction based on the Milliman report.

"At a time when line item expenses from monthly cellular service to auto insurance premiums are scrutinized, savings from electronic transactions can offer real additional value," says Polly Walgren; CMM, MBA, FACMPE; practice administrator, West Suburban Women's Health, Ltd.

Electronic tools are free
Aetna's collection of free electronic tools is available through Aetna's secure provider website via NaviNet®. Participating and nonparticipating physicians and other health care professionals who care for Aetna members can check eligibility and benefits in real time, submit or inquire about claims, review claim payment policies, view and print explanation of payments online within 24 hours of claims processing, and obtain electronic remittance advices (ERA) and electronic funds transfers (EFT). In addition to Web-based solutions, participating and nonparticipating physicians and other health care professionals can use Aetna Voice Advantage®, Aetna's interactive telephone self-service system that is available 24/7, to check coverage and benefits for multiple patients, receive fax-back copies of eligibility and coverage information, and check claims status.

To take advantage of Aetna's collection of electronic solutions, health care providers must register to use the company's provider website. Providers can also choose from more than 30 Aetna-approved vendors to connect with Aetna electronically. For more information go to https://www.aetna.com/provider/. The EDI Calculator is available at www.aetna.com/EDIsavingscalculator.

About Aetna
Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 36.5 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates.  For more information, see www.aetna.com.