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Florida Health Insurance HMO News


Florida health insurance HMO contracts have sought help of IT major Biometric Technologies, Inc. to introduce biometric testing for preventing and reducing health insurance frauds in Florida. Biometric technologies have a patented technology, which detects fraudulent healthcare claims. Biometric technologiesí BioClaim software uses biometrics to authenticate a patientís identity at the point of service.

Furthermore, It also provides an interface to connect the patientsí data and health insurance claims information with HMO claims system. Besides helping in establishing the identity of patient, the technology is proving helpful in preventing insurance frauds. The biometric system authenticates the identity of the individuals before providing medical assistance. In addition, it protects medical records of individuals and prevents any unauthorized access. Currently, BioClaim has been launched with only selected Medicaid providers.

The Biometric log-in device has replaced the general paper sign in sheet. The biometric device stores the unique finger print data. The finger print log in it proves that the patient had really visited the hospital. The entry also includes date, time and location and this template containing this information is stored in BioClaim central database. The software runs some mandatory processes when a florida health insurance claim is submitted. This system has successfully curbed the instances of phantom billing by the health insurance providers.

The new BioClaim software follows one rule - ďno fingerprint, no claim.Ē This new biometric system also prevents people from using insurance card of other people. The BioClaim software denies claim if the biometric data doesnít match. The basic function of the BioClaim software is to identify the patient correctly and in case the patientís fingerprint isnít available, it prevents any items from being billed.

Besides, Florida health insurance HMOs are likely to experience growth in their business as the Human services budget committee has put forth a plan to move 247,671 Medicaid recipients residing across 19 counties in Florida State to HMOs.

This move is expected to make savings of $28.6 million for the State in the coming year (2011). The total annual savings is expected to be around $100 million in the next few years. The HMOs were primary choice because they are already operating efficiently and have the capacity to serve larger population conveniently. Central Florida counties, which include Osceola, Orange and Seminole, along with Hillsborough, Palm Beach, Miami-Dade, and Pinellas counties are some of the regions, which have benefitted from this shift. Currently, around 1 million Medicaid patients are receiving managed care from HMOs.


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