In a typical year, approximately 5 to 20 percent of the population gets the seasonal flu, resulting in an average of 23,600 flu-related deaths across the United States. For older people, influenza and pneumonia is the seventh leading cause of death and more than 50 percent of flu-related hospitalization occurs in people age 65 or older.

In addition to the regular influx of patients requesting flu shots, providers are preparing to handle additional patients due to a new vaccination requirement proposed by the Centers for Medicare & Medicaid Services (CMS). The proposed CMS 3213-P ruling, which is due to be published as a final ruling in 2012, will require certain providers to offer Medicare and Medicaid patients an annual influenza vaccination. While the Centers for Medicare & Medicaid Services estimates the influenza vaccination ruling will cost $330 million annually, decreased medical care costs will be $710 million and savings in patient time amounts to $170 million. 

Providers have told us that they process an enormous amount of Medicare claims during September through December for the flu shot. As a result, IVANS have been working with healthcare providers across the country upgrade their technology solutions to support faster claims processing and information sharing so they can manage payments more quickly and securely.

To help healthcare professionals more easily manage the processing of these additional claims, IVANS LIME™ Health Information Exchange (HIE) provides an easy way for customers to get additional access to Medicare and Medicaid throughout the flu season. Being able to verify patient eligibility electronically is critical during the flu season, and healthcare providers can use IVANS LIME HIE platform to check Medicare eligibility online at the time of the patient visit. Medicare claims denied because of patient ineligibility are a leading source of uncompensated care. By checking a patient's Medicare eligibility electronically prior to administering the flu shot, providers eliminate timely phone verification and reduce their Medicare claims denial rates by an average of 50 percent.

Customers such as Rick Mieses, general manager of Medidyne Corp., a medical equipment supplier located in Fairfield, NJ, are very familiar with the benefits of using IVANS LIME HIE technology to conduct real-time Medicare eligibility verification. Mieses said, "Using LIME to check Medicare eligibility is saving us hundreds of dollars we would have incurred from uncompensated care. And, because we are able to perform patient checks directly from our desktop computer, our staff can re-focus their efforts on patient care instead of administrative tasks."

With flu season already knocking on many healthcare providers' doors, having the right technology at their fingertips will not only save you significant time and money but, most importantly, it will help you deliver preventative care in a more efficient manner to those who need it most. To learn more about IVANS LIME HIE platform and how to manage your claims more quickly and securely during the flu season, visit: www.ivans.com/healthcare. 

Michael Schramm is group vice president of product and innovation in IVANS healthcare business unit.