The payers' automation challenge.

Abstract

Despite some success stories, most of the nation's 300 commercial insurers and hundreds of managed care plans are in the earliest stages of using electronic data interchange for health care transactions. However, there are some encouraging signs of progress in the effort to shift to EDI, as more payers offer providers incentives to automate. Payers blame the relatively slow progress on cost, the absence of universally accepted standard electronic formats and uncertainties over the political debate on health reform. But providers say many commercial payers are moving too slowly to automate and are expecting providers to bear too much of the financial burden.