Harvard Pilgrim Health Care and Perot Systems Successfully Implement Payer/Provider Collaboration Via Open Architecture Web Services

WELLESLEY, Mass. and PLANO, Texas, Feb. 24 /PRNewswire-FirstCall/ -- Harvard Pilgrim Health Care, Inc. and Perot Systems Corporation have developed an open architecture solution that enables healthcare providers to effectively exchange secure HIPAA-compliant transactions (e.g., claims, eligibility, etc.) with Harvard Pilgrim via Web services. This new tool, a feature of Harvard Pilgrim's electronic transaction Channel Strategy, is now effectively processing several thousand transactions per week at no additional cost to physicians and health systems using this method.

"The dynamics of the healthcare marketplace have created tremendous incentives for providers and health plans to directly connect around processes that reduce costs, while increasing the quality and value of shared information," said John Kelly, business architect for Harvard Pilgrim's Channel Strategy. "We are now able to reach a much broader segment of our provider network with this new, cost-effective solution for direct integration with their office desktops. Providers are seeing benefits as well, such as automatic responses and receipt notifications. When more payers and providers adopt this type of direct business-to-business model, everyone in the industry will see the financial benefits."

"Perot Systems has worked with Harvard Pilgrim to integrate and leverage the advantages of the Internet, open standards, scalable messaging architectures, and transactional security measures to enable secure, real- time, quality transactions between payers and providers that are compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other regulatory requirements," said Matthew Kristin, Perot Systems chief architect for Harvard Pilgrim. Kristin added, "Implementing a solution that can support both large hospitals and the small provider office is a significant benefit."

"The Web-services, standards-based solution accommodates several different types of interactions, including real-time and batch processing, and various data formats, including both Electronic Data Interchange (EDI) and non-EDI transactions," said Larry Rapisarda, Harvard Pilgrim's chief technology officer. "This solution gives us improved data quality, improved customer satisfaction and reduced operational costs."

Perot Systems began working with Harvard Pilgrim in 1999 under a 10-year strategic integrated business and technology services agreement. In 2002, that agreement was extended two years and the services expanded.

In addition to Web Services, Harvard Pilgrim and Perot Systems have previously implemented HPHConnect, a Web-based portal that has made it easier for members, providers, and employers to access information and tools that help administer their relationships with Harvard Pilgrim.

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