U.S. Introduction of One Inc's ERA Solution in the Marketplace

In a move aimed at enhancing operational efficiency and reducing costs within the U.S. healthcare system, Charles Taylor has launched Guardian Managed Care Solutions, an independent medical bill review company. This new entity operates separately from any medical networks and offers cost containment services for employers, TPAs, insurance companies, government entities, self-funded payers, and international payers.

The launch of Guardian Managed Care Solutions is not limited to domestic markets. The company's services are also extended to international payers, particularly those serving migrant workers. In a partnership with Axa, PartnerRe, and RemitRadar, a new product has been launched that aims to cater to customers sending money overseas.

One Inc, a leading provider of digital claims solutions, has also made strides in the remittance process. They have launched an advanced 835 Electronic Remittance Advice (ERA) solution integrated into their ClaimsPay platform. This solution streamlines remittance processes for healthcare providers, particularly benefiting workers' compensation insurers, and extends its capabilities across all Property and Casualty (P&C) insurance segments.

The broader adoption of 835 ERA files could yield annual cost savings of $695M for the U.S. healthcare system, according to research from the Council for Affordable Quality Healthcare. This is due to fewer errors, faster processing times, and streamlined administrative tasks. The enhanced ERA functionality within ClaimsPay enables insurers to generate and distribute standardized 835 remittance files directly to providers' Revenue Cycle Management (RCM) systems.

By providing detailed line-item data crucial for accurate claims payment reconciliation and matching the 835-remittance data directly with the corresponding payment, the solution significantly enhances payment accuracy, accelerates reconciliation, and reduces administrative workloads. This advanced remittance capability ensures the payment process is more precise, transparent, and beneficial for all stakeholders.

In a related development, an insurtech startup based in the UAE, Democrance, has partnered with AXA to launch a personal accident insurance scheme for customers of the international money transfer service Hello Paisa. This scheme is a testament to the growing importance of integrated insurance solutions in the global remittance market.

Ian Drysdale, CEO of One Inc, stated that the integration of comprehensive ERA capabilities within ClaimsPay empowers insurers to meet or exceed stringent regulatory demands while significantly boosting operational efficiency. However, it is unclear which insurers currently use the 835 Electronic Claim Recommendation from One Inc.

Fewer than 20% of workers' compensation claims currently use 835 ERA files, indicating a significant opportunity for improvement and cost savings in this area. The launch of Guardian Managed Care Solutions and the advancements in remittance capabilities by One Inc are steps towards realizing this potential.