UC San Diego Health is working on a SMART insurance card initiative — a new model for digitally standardizing and modernizing health insurance cards, streamlining patient check-ins and reducing billing errors.
During a recent digital health symposium, UC San Diego Health’s Christopher Longhurst, M.D., 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.
UC San Diego Health says it 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, in a statement. “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 pandemic by most of the U.S. healthcare 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, in a statement. “We believe that adopting this standard will enhance the efficiency and effectiveness of health care services, and thereby benefit patients and providers alike.”
“UC San Diego Health is situated as a key decision maker in healthcare delivery, and SMART Health Insurance Cards are a great opportunity for us to showcase our innovation skillset, mindset and leadership for improving the healthcare ecosystem,” said Joshua Glandorf, chief information officer for UC San Diego Health, in a statement. “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.”
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.
