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Neighborhood Health Partnership, Inc. (Miami) Selects ENS, a
subsidiary of NWH, for E-Commerce Services
- Full-service, national health care e-commerce company to manage Neighborhood
Health Plan's claims transactions
NEW YORK, Sept. 8 /PRNewswire-FirstCall/ -- Electronic Network Systems, Inc.
(ENS), a subsidiary of NWH, Inc. (NASDAQ:NWIR), announced that Miami,
Florida-based Neighborhood Health Partnership, Inc. (NHP) has selected ENS to
provide transaction services for claims to its providers.
"This partnership with ENS will be our third Clearinghouse connection," said
John T. Fries, NHP's Executive Vice President. "We have found that during the
sales and implementation process, ENS has provided superior service in
comparison to others in the industry. NHP and ENS agree that building this
connection is the first step, and that ultimate success will rely upon
strategic marketing and quality service to the provider market. Our goal is to
increase our electronic claims processing to 50% within the first year. We are
confident that ENS' PASS(TM) services will enhance our claim-submission process
while providing additional EDI options to more providers and reduce
administrative costs at the same time."
ENS' Pre-Adjudication Software System (PASS(TM)) automates complex business
rules and processes. PASS(TM), which will be implemented for NHP's HMO and PPO
business, will help streamline transaction flow, increase auto- adjudication
rate, eliminate duplicate claims, and populate a specific NHP Preferred
Provider ID, which many providers have not been able to provide in their
current EDI files to date. Thereby, PASS(TM) allows NHP to receive clean
electronic claims, which reduces associated costs with paper claims and
increases electronic claim volume.
Dean Politi, ENS Senior Vice President of Payer Services said, "The robust
functionality of our PASS(TM) solution enables NHP to increase the ability for
more providers to send electronic claims due to the upfront claims pre-
adjudication process, which helps increase its adjudication rate while
recognizing and reducing errors and unwanted duplicates."
Politi explained that PASS(TM) is tailored to meet the complex internal
business logic of each payer to provide real-time eligibility verification with
automated member and provider matching to the payer's host system records.
"Any procedures manually interpreted by adjudicators today can now be automated
by PASS(TM) with the added benefit of detailed transaction logging and audit
reporting," he concluded.
Le Ann Eyres, ENS Director of Payer Services stated, "NHP chose to partner with
ENS for several reasons, but primarily to gain its substantial connectivity
within the Florida market and to utilize ENS' Xpedite(TM), a proven marketing
plan that will immediately track and measure EDI growth once the connection is
live. In this industry, there is more to signing the contract and building a
direct connect -- it is the delivery of ENS' commitment and its services that
make the difference."
ENS' leading-edge health care transactions platform offers a single interface
to conduct all HIPAA-defined transactions between payers and providers
nationally, minimizing paper-intensive and labor-intensive processes.
About Neighborhood Health Partnership
Neighborhood Health Partnership is a South Florida based HMO providing
Commercial managed care benefits to the residents of Miami-Dade, Broward and
Palm Beach Counties; and Medicare+Choice benefits to Miami-Dade and Broward
Counties. As of May 1, 2004, NHP serves approximately 185,000 members.
About NWH, Inc. and ENS
NWIR was organized in 1993 as a holding and strategic resource company
concentrating its resources on the acquisition, finance, development and
management of telecom, healthcare services, technology and media businesses.
Its principal operating subsidiary, Electronic Network Systems (ENS)
(http://www.enshhealth.com/) provides Internet and e-commerce connectivity
between thousands of health care providers such as physicians, hospitals,
clinics, practice management software vendors and third party commercial
payers.
ENS is currently processing transactions annually from more than 200,000
providers. ENS provides services to healthcare providers and payers that
eliminate paper and labor-intensive process in the administration of healthcare
delivery. ENS provides and supports Health-e Network(R), a full cycle suite of
products and services designed to increase productivity, automate, and
streamline workflow between providers and health care payer organizations.
Contacts:
Neighborhood Health Partnership
Elizabet Miranda - Provider Relations
305-715-2490
Electronic Network Systems (ENS)
Dean Politi
Senior VP Payer Services,
800-341-6141
DATASOURCE: Electronic Network Systems, Inc.
CONTACT: Elizabet Miranda, Provider Relations, Neighborhood Health
Partnership, +1-305-715-2490, ; or Dean Politi,
Senior VP Payer Services, Electronic Network Systems (ENS), 1-800-341-6141,
Web site: http://www.enshhealth.com/