Blue Cross Blue Shield adds customer service office at Wake Forest Baptist [Winston-Salem Journal, N.C.]

Oct. 24--The state's largest health insurer, Blue Cross Blue Shield of N.C., said Wednesday it has opened a customer service and claims site at Wake Forest Baptist Medical Center.

It is the first on-site presence staffed by Blue Cross personnel in a Triad hospital. The insurer has a similar presence at Duke Health System, WakeMed, UNC Hospitals and with UNC Physicians and Associates.

The insurer said its program at WakeMed -- which started in 2009 -- is resolving more than 60 percent of claims on the first day they are received at that hospital and more than 70 percent in two days.

Blue Cross is providing services at Wake Forest Baptist from 8 a.m. to 5 p.m. weekdays.

The goal is to improve communication between patients, Wake Forest Baptist staff and the insurer, as well as speed up the resolution of patient claim inquiries and questions.

"Patients often have questions and concerns about their medical bills and what their health insurance will cover," said Alan Hughes, Blue Cross' chief operating officer.

"It can be a complex process to navigate. We can get (customers') insurance questions answered faster, so they can get back to their normal lives as quickly as possible."

Another motivating factor for the program "is making sure claims paperwork is done correctly the first time," said Michelle Douglas, Blue Cross' public-relations manager. "This eliminates the need to rework claims and ensures they get paid faster."

Chad Campbell, a Wake Forest Baptist spokesman, said the hospital is participating "to help in the revenue cycle to ensure timely processing of claims and resolution to outstanding claims issues." He said no other insurer is providing this type of on-site services.

Campbell said two Blue Cross officials are on the main Wake Forest Baptist campus, along with four embedded in its revenue-cycle unit and other officials at the center's Kimel Park facilities. Each Blue Cross office has signage indicating its presence.

Douglas said Wake Forest Baptist was chosen as the first Triad hospital site in part because of logistics.

"Wake Forest Baptist houses all of its billing professionals in one centralized location," Douglas said. "Being able to place Blue Cross claims professionals in the same building makes it easier for us to collaborate."

Blue Cross holds 59 percent of the health insurance market share in the Winston-Salem metropolitan statistical area, which consists of Davie, Forsyth, Stokes and Yadkin counties, according to a 2011 American Medical Association study on insurer competition. It also holds 50 percent market share in the Greensboro-High Point MSA, which consists of Guilford, Randolph and Rockingham counties.

Douglas said the insurer plans to offer the program in other hospitals in the Triad and state.

To learn more about the insurer's on-site service programs, go to http://connect.bcbsnc.com/lets-talk-cost/on-site-service/.

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