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PCS HEALTH CARE INFORMATION NETWORK AVAILABLE TO 40,000-50,000 DOCTORS

Executive Summary

PCS HEALTH CARE INFORMATION NETWORK AVAILABLE TO 40,000-50,000 DOCTORS in nine states as the "initial step in creating the first nationwide electronic data interchange for health care," PCS said Sept. 7. Operational as of Sept. 1, "the network enables hospital, medical and dental providers to use their office computers to instantly verify patient eligibility and benefit coverage, out-of- pocket expenses and coverage exceptions for people insured under managed care and indemnity programs offered by multiple payors," PCS said. The network is currently available in California, Texas, Florida, Illinois, Ohio, Virginia, New York, New Jersey and Connecticut. By the end of 1994, PCS expects the network to be operational in the 50 largest markets in the U.S. with over 100,000 health care professionals hooked up. The company estimates that "80 mil. Americans potentially could be served by the system." The network is "parallel" to PCS' pharmacy RECAP system, the McKesson subsidiary said. RECAP provides pharmacies with benefit information at the pharmacy and "will adjudicate nearly 200 mil. pharmacy claims In 1993," PCS said. PCS is operating the Health Care Information Network (HClN) on behalf of the National Electronic Information Corp., a group of insurers including Metropolitan Life, John Hancock, PacifiCare, Aetna and Cigna. NEIC works with software vendors to install the system in physicians in-office computers. NEIC is currently providing the network through eight vendors and is working with another 20 to expand availability. The network was tested in California, Texas, Virginia and Ohio in 500 health care professional' offices using six vendors, PCS said. Physicians were surveyed on usage and their opinion of the network's speed and utility. "In the future, HClN will include additional capabilities such as authorizations, referrals and claim status inquiries," PCS said. "Payors do not want to replicate the expense or the research and development time to build these systems that are being supplied by PCS," the company added.
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