e-Payment system close Karen Dearne
JANUARY 17, 2006
HEALTH industry transactions specialist ICSGlobal could be providing Medicare payments electronically this year.
Federal Human Services Minister Joe Hockey has sought private-sector interest in running the huge-volume Medicare payments business, which handles about 235 million claims, worth about $9 billion, each year.
ICSGlobal managing director Tim Murray says the company's Transactional Health Exchange Linking Multiple Applications technology (THELMA) is "a perfect fit".
"There is nothing else already in existence that's competitive," he says.
"There's only one THELMA and since Medicare Australia wants something now, that's good for us.
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"Our technology was developed years ago and it has only been bureaucratic machinations that have prevented it being used."
THELMA is an exchange hub that enables clinical, financial or administrative communications between technology systems so any user can do business with any other user.
Customers pay a transaction fee each time they use THELMA, but because the service is accessed over the internet there is no need to buy special hardware or software.
Clients include private hospitals, health insurance funds, medical specialists and allied health professionals.
Medicare Australia is now part of the mammoth human services portfolio of six agencies, which together deliver about $90 billion in payments and services each year.
It is seeking an electronic system that will allow claims to be verified and approved, and rebates deposited into customer bank accounts in 24 hours.
Responses are due by next Tuesday and a government decision on a proposal is expected by May.
In a letter to shareholders last month, Mr Murray said millions of dollars had been pitched at other hospital claims systems, but fewer than 15 per cent of hospital claims were being sent electronically through non-THELMA infrastructure.
"These are point-to-point systems that were hard-wired to the requirements of each health fund and hospital, and each new connection is a significant technology project in itself," he said.
"When you realise that every hospital is different and every health fund is different, it's not hard to see that the number of separate projects required to establish high levels of connectivity quickly renders these point-to-point systems unviable.
"That's why we built THELMA as an any-to-any configurable hub."
THELMA was the only means by which the vast majority of hospitals were able to send electronic claims to health funds without a major capital investment, he said.
ICSGlobal was positioning itself to work with other industry players, including banks, Mr Murray said.
A lot of parties had approached his company to see whether it could work with them, he said.
"Our view is that we can work with everybody," he said.
In particular, ICSGlobal had been working with the Commonwealth Bank since September 2004 on a new Medicare claims and payment system "in anticipation" of the latest initiative.
THELMA already processes directly to Medicare a range of bulk billing claims from medical specialists and radiology/pathology providers.