Keywords: electronic medical record, real time, claims system, Medicaid primary care, sentinel events, clinical markers, health care
A State's use of the electronic medical record: a means to address Arkansas' health care responsibilities to her children - promoting access to cost-effective care
A state-wide approach to finance health care for children, 18 and under, through Arkansas Project Access (APA) began with the intention of creating a seamless, quasi-public system through which a state-wide, paediatric/adolescent managed care system would be established. Successful managed care systems require a valid system of communication that is robust, timely, user-friendly - one that integrates essential data elements to foster adherence to programme goals, as well as reduces hassles for claims payment. The Arkansas Verification of Eligibility and Claims Submission System (AVECS) was jointly developed by the States Medicaid Office and a for-profit data system corporation. Three types of data input devices were furnished providers, the choice of which was based on individual, user preference. The system became mandatory for claim submission as of summer 1993. Administrative costs are less than 10 cents per transaction. Payment is made in a timely fashion, i.e., ten working days - far faster than most private insurance plans. Provider payment denials have declined from an average of 25% to 30% with paper claims to an average of only two to 10% with the AVECS.