UC San Diego Health Spotlights SMART Health Insurance Cards

Highlights:

• First demonstration of new QR code standard for health insurance cards.
• New model will allow providers to scan QR code, verify its authenticity and ingest the data into their systems automatically.
• Collaborating partners include UC San Diego Health, UC Irvine Health, UCLA Health, UCSF Health, UC Davis Health, UCR Health, Evernorth Health Services, Healthcare Financial Management Association, The Commons Project, VCI Coalition and CARIN Alliance.

During a digital health symposium this week, Christopher Longhurst, MD, with UC San Diego Health, pulled up a QR code from his phone’s digital wallet, scanned it at a check-in kiosk and instantly displayed how his medical insurance information was retrieved and verified in real time, including copay amounts.

The UC San Diego Health digital health symposium was the first demonstration of the SMART health QR codes for health insurance cards initiative — a new model for digitally standardizing and modernizing health insurance cards, streamlining patient check-ins and reducing billing errors. UC San Diego Health is the first health system in the nation to pilot this innovative new approach.

“There are more than 1,000 health insurance companies in the United States, each with their own insurance card format,” said Longhurst, chief medical officer and chief digital officer at UC San Diego Health. “It takes weeks to train new staff members to decipher all those different card formats, and there are often typos, which can lead to rejected insurance claims. Having a common QR code format to scan will streamline the process, reduce errors and simplify insurance documentation for our patients and staff.”

Although many health plans have recently launched their own digital member identification cards, there has not been a common standard that allowed providers to easily scan or ingest that information — until now.

The new SMART Health Insurance Card is based on the SMART Health Card QR code standard that was adopted for verifiable vaccination records during the COVID-19 pandemic by most of the U.S. health care and technology ecosystems, including: most U.S. states, national pharmacy chains, health providers and insurers and mobile and technology platforms.

The SMART Health Insurance Card initiative was launched by The Commons Project, in collaboration with the CARIN Alliance and the VCI coalition of public and private partner organizations that developed the SMART Health Card standard.

The new SMART Health Insurance Card initiative garnered support from the Healthcare Financial Management Association (HFMA) in April, a nonpartisan professional practice organization that represents 100,000 health care financial management professionals nationwide.

“We urge our health care system colleagues, payer partners and electronic health record practice management system vendors to actively participate in the SMART Health Insurance Cards initiative and embrace the SMART Health Card standard for health insurance cards,” said Richard L. Gundling, senior vice president, professional practice at HFMA. “We believe that adopting this standard will enhance the efficiency and effectiveness of health care services, and thereby benefit patients and providers alike.”

The UC San Diego Health symposium, where the demonstration took place, is happening at the Qualcomm Institute and is honoring Irwin and Joan Jacobs for their generous support of $22 million in gifts to expand UC San Diego Health’s Center for Health Innovation.

Prominent thought leaders from academia and industry are sharing ideas and key initiatives about innovations in health care through AI and machine learning, mobile health data driven service models and ethical and secure practices in digital health, including the launch of the SMART Health Insurance Card.

“UC San Diego Health is situated as a key decision maker in health care delivery, and SMART Health Insurance Cards are a great opportunity for us to showcase our innovation skillset, mindset and leadership for improving the health care ecosystem,” said Joshua Glandorf, chief information officer for UC San Diego Health. “There is a strong alignment with these new SMART insurance cards and how we’re aiming to advance health care in the digital space as a whole.”

“This is an exciting step forward in our work to make health care simpler for those we serve,” said Glen Stettin, MD, chief innovation officer for Evernorth Health Services. “SMART insurance cards have the potential to help patients get faster access to needed care, and help doctors get reimbursed more efficiently. Any organization interested in removing friction in health care should consider them.”

Following today’s demonstration, UC San Diego Health, UC Irvine Health, UCLA Health, UCSF Health, UCR Health and UC Davis Health will conduct further pilots of the model.

HFMA is also forming a working group of large health systems nationwide to collaborate with their payer and electronic health record vendor partners to pilot the model in coming months. After the pilots, the participants will assess the outcomes and strive for the widespread implementation of the standard and the model during the upcoming benefit year starting in January 2024.

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