October 23, 2007 - Chatsworth, CA - Electronic Health Plans, Inc. (EHP) announced today that it has begun implementation of version 1.9 of its internally developed breakthrough technology that automatically adjudicates healthcare insurance claims without intervention by claims examiners.

EHP, which currently offers a comprehensive suite of services to its Managed Care clients, now has a propriety state-of-the-art claims system that achieves in excess of 95% auto-adjudication rates on all healthcare insurance claims, not just “simple” claims. It also encompasses other important aspects of managed care including case and episodic controls, individual provider contracts, complete encounter processing for capitated services and web-based medical authorization services.

The EHP system not only produces extraordinarily high rates of claims auto-adjudication, but does so while producing the highest audit results. This is shown by our continually high compliance ratings from external audits conducted by health plans such as Blue Cross and Blue Shield in California. This combined achievement is what healthcare administrators are seeking to improve their business, increase margins and meet compliance.

The EHP system is designed to take full advantage now, with authorizations, and in the future, with claims adjudication, of the real time environment that is possible via the web. Last month we successfully rolled out our new, web-based Prior Authorization System with a major client.

Duane Roberts, CEO, commented, “With all of the many levels of automation developed in the last 50 years, the Claims Examiner remains firmly at the center of the claims adjudication process. Today, there are literally tens of thousands of claims examiners in the United States, the vast majority of whom work with automated systems, most of which are on-line, and all designed to aid these examiners with their jobs. The EHP system changes the basic human examiner centric process of claims administration because our system was designed to REPLACE the claims examiner, not simply augment the tasks that the examiner must perform. In the EHP world, the system IS the Claims Examiner.”