Provider Adoption Report

The following reports are intended as a representative sample of provider usage of health plan call centers and web site capabilities. Health plans will report provider usage every three months starting with the period of Jan-March 2011. (Health Plan reporting is voluntary.) Ideally, provider usage of call centers will trend downward and usage of web site capabilities will trend upward. The most recent quarter is displayed with total line showing percentage change from pervious quarter totals. A trend report of multiple quarters offers an easy display of the change over time. Previous quarters are listed at links for viewing. Click on the link of the quarter you wish to view, click again to close quarter.

Adoption of Prospective Review

Adoption of Eligibility & Benefit Capability

All reporting health plans have adopted the 'BPR - Requesting and Receiving Coverage Information for Eligibility & Benefits'. This reports tracks provider phone calls for Eligibility & Benefits information along with usage of the health plans web site to obtain that information.

Click Here to see Q3 2011- Adoption of Web Eligibility and Benefits

Eligibility and Benefits checking	Call Volume		Web Usage
	# of E&B calls*1	E&B calls*1 as a % of Total Calls*1	# of E&B requests	# of unique provider organizations making E&B requests	Average # of E&B requests by organization
Total - All Reporting Health Plans	214,780	47%	2,100,963	13,428	156
Group Health:	36,169	55%	665,580	3,703	180
Molina Health Plans:	15,564	33%	386,189	964	401
Premera Blue Cross:*2	120,366	45%	772,186	8,570	90
Regence BlueShield:	42,681	58%	277,008	8,098	34
Foot Notes:	*1 - Provider calls		*2 - Includes non-Washington State data

 

Click Here to see Q2 2011- Adoption of Web Eligibility and Benefits

Eligibility and Benefits checking	Call Volume		Web Usage
	# of E&B calls*1	E&B calls*1 as a % of Total Calls*1	# of E&B requests	# of unique provider organizations making E&B requests	Average # of E&B requests by organization
Total - All Reporting Health Plans	204,071	40%	2,054,842	11,241	183
Group Health:	38,941	57%	669,567	3,610	185
Molina Health Plans:	7,703	9%	382,463	1,054	363
Premera Blue Cross:*2	113,054	39%	693,989	8,405	83
Regence BlueShield:	44,373	64%	308,823	8,201	38
Foot Notes:	*1 - Provider calls		*2 - Includes non-Washington State data

 

Click Here to see Q1 2011- Adoption of Web Eligibility and Benefits

Eligibility and Benefits checking	Call Volume		Web Usage
	# of E&B calls*1	E&B calls*1 as a % of Total Calls*1	# of E&B requests	# of unique provider organizations making E&B requests	Average # of E&B requests by organization
Total - All Reporting Health Plans	236,253	46%	1,893,228	10,524	180
Group Health:	42,722	59%	622,703	3,844	162
Molina Health Plans:	17,213	29%	401,158	939	427
Premera Blue Cross:*2	124,297	40%	558,964	7,443	75
Regence BlueShield:	52,021	74%	310,403	7,916	39
Foot Notes:	*1 - Provider calls		*2 - Includes non-Washington State data