Highmark Implements Babel Health Solution for Improved Medicare Advantage Submission Results
Summary
Highmark — the fourth-largest overall Blue Cross Blue Shield-affiliated organization, covering the insurance needs of 5.6 million members in Pennsylvania, Delaware, and West Virginia — partnered with Babel Health to improve workflow and program efficacy, align their data, increase their submissions, while continuing to maintain full compliance. Before Babel Health, Highmark utilized an in-house approach that required following multiple processes on separate information systems for EDPS and RAPS submissions. “The need to simplify our processes and better leverage our resources was the driving force that led to finding a solution that streamlines our submissions and continuously improves quality,” said Olga Ziegler, VP, Revenue Program Management at Highmark. With Babel Health, Highmark can work through RAPS and EDPS encounter submissions on the same platform. “As we see changes in regulations and the introduction of new products, it is crucial that we continue to improve the workflow and maintain compliance,” noted Ziegler.