This is one more sign of technology taking over work where humans used to the jobs and it is moving today at rocket speeds everywhere.  In this press release the imagecompany clearly states this, again as I say we have swords to do battle with and they have machine guns in the infrastructure and technology areas.  From last week I posted about expecting more scoring to occur with the changes in healthcare reform and this is all carriers, not just Blue Cross.  “Fraud” is the catch all reason for investigating claims and some are fraud and some merely get false positives.  When you are a false positive at times, it’s almost like you have been convicted of fraud already and need to prove innocence.  No doubt we need this capability to audit claims, but we also need the ability to have audit trails on the parameters used so they don’t cross the line, as in the Ingenix inquisition where lawsuits are still ongoing and perhaps more coming where the lines were crossed and it was not the patients and doctors with a case of fraud as it was the opposite. 

Healthcare Reform Bill – Expect “Fraud Algorithm” Use to Increase With “Scoring” the Insured With Our Leadership Trapped Embellishing Old Paradigms

Good question with all of this, who do you trust?  We get to see Medicare’s formulas and algorithms and have somewhat of a say there, but the ones run by insurers are anyone’s guess.  Back on track, we saw what record profits were made by insurers, but when algorithms can do faster what humans have done, well we know the story there.  Be aware.  BD 

HARRISBURG, Pa., March 31 /PRNewswire/ -- Capital BlueCross today announced that it has eliminated 182 positions as part of its ongoing effort to increase efficiency and lower its operating costs.

Capital BlueCross' ongoing cost-control efforts have included evaluation of how new technologies have improved its efficiencies in various operations, such as claims processing.  This technology has resulted in increased productivity, while gradually decreasing the needed manpower.  Technological advances accounted for many of the job reductions announced today at Capital BlueCross and its subsidiary companies.

"At Capital BlueCross, we have been doing what all businesses are doing during this uncertain economic time -- we're looking at every way possible to be more efficient, to keep our costs down, and to be even more competitive and strong," said William Lehr, Jr., Capital BlueCross President & CEO. "Advances in technology, particularly, enable us to reduce our costs at Capital BlueCross and its subsidiary companies, while still providing award-winning service.

Capital BlueCross Eliminates Jobs -- HARRISBURG, Pa., March 31 /PRNewswire/ --


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