HBN Alert System

One of the greatest challenges for practices is the communication of payer’s new policies and procedures. Health Business Navigators (HBN) has teamed up with Medical Present Value, Inc, (MPV) to offer HBN clients a viable solution, HBN Alerts.

How the Alerts Work The pace of policy and procedural change has accelerated greatly in the last few years due to insurance company network mergers and acquisitions, consolidation, and the need to reduce healthcare spending. Insurance companies and healthcae policies are designed to minimize their costs. These policies can erode your bottom line and add administrative complexity to your practice. Constant changes to policies and procedures—by which you are contractually bound and must abide—guarantee that more premium dollars stay with the payers and less reimbursement goes to you. Today, the payer side of the industry generally uses Web sites, instead of paper manuals, to house and update policies and procedures. Until now, no one has been monitoring these activities cohesively, let alone alerting you about them. Without that level of transparency, you’ve been operating in the dark. The Alert system puts the right practical information in your hands, in a way you can use, allowing you to minimize costs, streamline operations, and protect your bottom line.

Subscribe now: Every day, 70,000 Web pages operated by more than 200 insurance companies and plans are monitored by MPV, recording any relevant changes, segmenting items by specialty, and classifying them into the appropriate categories including administrative, clinical, reimbursement, and pharmacy. When you register, you can subscribe to all four categories or select only the ones you wish to track. Additionally, you can assign different categories to different email addresses, so the right people in your organization get the right information.

Concise and relevant: Every night the system automatically issues alerts, which include the company or plan, the title of the policy or information piece, an overview of the material, the date the change takes effect, and a hyperlink that takes subscribers directly to the site of the insurer or plan for more information.

Way beyond billing: Don’t think that just because you use (or are) a billing service you don’t need to be a subscriber. Practices need to know about important information that affects how they do business at various levels. For example, not knowing about administrative changes such as procedures that get added to notification or preauthorization lists and other day-to-day process changes can cost you money. Stop waiting for EOBs to learn about denials that you might have avoided if you were aware of reimbursement policy changes. You also need to know about clinical changes, such as being able to administer Flumist to pediatric patients that previously were not covered, or previously covered procedures that are now only eligible if performed in an in-patient setting. Pharmacy changes are fast becoming unmanageable, with many former drugs now requiring medical pre-approval or removed from formularies altogether. To the extent that payers and plans post their policy changes to their sites, HBN Alerts make sure that you receive the right information at the right time and that it reaches the people in your organization best suited to act upon it.