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National association recognizes Capital BlueCross for Simplifying transfer of patient information

New process saves money and time, improves accuracy

HARRISBURG, Pa. (Aug. 23, 2012) – The Blue Cross Blue Shield Association (BCBSA) will honor Capital BlueCross on Aug. 27 with the Federal Employee Plan (FEP) Best Practice Award for developing an innovative benefits verification audit program.

All Blue plans use a universal system called BlueExchange to allow providers access to patient benefit information electronically, regardless of which plan houses the membership. Capital BlueCross created a new decoding process that simplifies the conversion and validation of benefit levels, such as for covered services, pre-authorization, provider network and out-patient co-pay. This is all done in accordance with privacy laws pertaining to patient information.

The decoding system has reduced the volume of pages an auditor manually goes through from 1,100 pages down to two during the validation process. This has not only increased the accuracy of the process, but also it has reduced the decoding of a service to mere minutes versus what once took many hours. Capital BlueCross’ new process is being recommended by the BCBSA as something from which all Blue plans could benefit.

“Ultimately our efforts to streamline this audit process have resulted in a better customer experience for our federal employees,” said Gary D. St. Hilaire, Capital BlueCross President & CEO. “This award validates Capital BlueCross’ continued efforts to bring medical value to the community through improved satisfaction, better quality products and services, and by reducing costs.”

Capital BlueCross is the leading health insurer in its region, providing health insurance coverage to residents in central Pennsylvania and the Lehigh Valley.

Capital BlueCross is committed to making health insurance simple for its customers and members through all the stages of life by offering nationally acclaimed customer service and a full range of innovative benefit programs for groups and individuals at competitive prices.

By establishing a culture of caring, Capital BlueCross constantly strives to do more in order to deliver more for the men, women and children who depend on the company for their health insurance needs. Capital BlueCross has been providing medical value to the people and communities of central Pennsylvania and the Lehigh Valley for more than 70 years and employs over 1,800 people in the region.

Headquartered in Harrisburg, Pa., Capital BlueCross is an independent licensee of the Blue Cross and Blue Shield Association.

More information about Capital BlueCross and its subsidiaries can be found by going to