CAROLINA CARE PLAN OFFERS REAL-TIME CLAIMS PROCESSING SYSTEM IN SOUTH CAROLINA

November 4, 2009

Columbia, SC-- Carolina Care Plan has developed its own Real-Time Claims Adjudication (RTCA) system to enable patients to instantly take care of financial obligations at the point and time of their medical care.

Introduced in October 2008, RTCA was piloted by four physician offices. Feedback from the physicians of varying specialties indicates that the system is easy to use and patients too, find it easier to conduct business at the point of service.

“The results are encouraging,” said Donald Pifer, vice president of Network Management. “As for expediency, the claims submitted are fully adjudicated and returned to the physician and member in seconds,” Pifer said.

The web-based RTCA system was developed in-house by parent company Medical Mutual of Ohio and mirrors the layout of a claim form. The system provides users with the status of a completed claim within seconds of submission. The resulting documentation is an Explanation of Benefits (EOB), which is printed and provided to the member for his/her records.

The RTCA system was integrated into Carolina Care Plan’s Provider e-Portal earlier this month, allowing all network physicians to utilize the system. In addition, an internal RTCA steering committee is monitoring progress made on claims cost estimators, which may be coupled with the RTCA system to offer additional value to Carolina Care Plan’s providers and members. RTCA and the upcoming claims cost estimator will be accessible through Carolina Care Plan’s new Provider e-Portal, or the members’ My Health Plan website at http://www.carolinacareplan.com.

“This is an important step for our customers and provider clients because, as the transformation of the healthcare marketplace continues, Carolina Care Plan recognizes that consumerism and transparency will be significant components,” said Pifer.

About Carolina Care Plan: Founded in 1984 and headquartered in Columbia, South Carolina, Carolina Care Plan is a wholly -owned subsidiary of Medical Mutual of Ohio, one of the nation’s oldest health insurance companies. Carolina Care Plan offers quality, accessible, affordable and user-friendly health - coverage products throughout South Carolina. Carolina Care Plan serves as a partner to its clients, providing innovative, long term healthcare solutions through  its  products and services. For more information, please visit the company’s Web site at www.CarolinaCarePlan.com.