Web-based software helps to reduce costs for payers and providers

Sep 10 2009

"It's rare that you find anything that's win-win when it comes to payers and providers. However, as healthcare is looking for efficiency and savings, our company has created a mutually beneficial model that is rewarding, valuable and necessary. It's based on capturing and exchanging a unique piece of provider-submitted, non-billing patient data, whereby payers will find and subsequently recover many previously missed injury claim recoveries. The significant increase in payer revenue will make the participating provider a more valuable asset to payers, who may be able to thereby pass on savings to policyholders," says Stephen Ambrose, Chief Information Officer and founder of SubroShare(R).

Ambrose's company has set its sights on being an impartial 'exchange mediator' between payers such as health insurers, TPAs, self-funded plan sponsors and the estimated 350,000+ in-network health provider practices residing within payer and PPO panels.

SubroShare(R) is a web-based data repository, which securely stores and exchanges patient release of information (ROI) requests made upon a health plan policyholder, typically from an attorney, where such a request would indicate the presence of first or third party injury claim. The exchanged ROI data and transaction does not require patient authorization, as it falls under the provision of 'payment' under HIPAA law.

The CIO adds, "SubroShare and its patent-pending technology essentially accomplish three things. First, it is the only data exchange to alert payers, which of their policyholders has filed an injury claim, as well as the policyholder's attorney contact information. Second, it makes personal injury attorneys, who re-bill previously paid health bills accountable for their part in helping reduce costs in our healthcare crisis. Finally, it helps payers to better stabilize rates to policyholders, by not passing on wasteful injury claim payments."

Joining SubroShare is free for both payers and providers. It is web-based and an add-on product for payer's existing subrogation operations, so there is no major integration needed. Furthermore, the provider transaction consists of a quarter-page form with a copied sheet, either faxed or securely uploaded to the secure exchange. You may learn more at www.subroshare.com.