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The ordeal is disturbingly familiar to just about anyone who has been through the nation's managed health care bureaucracy: paper mounds, multiple referrals, and the incessant cattle call known as "open enrollment."

Net entrepreneurs face the same experience, but from the other end of the system. And what they see is something decidedly different: big money.

Even as public griping over health care surpasses baseball as America's favorite pastime, clearinghouses for insurance companies, health maintenance organizations, and various care networks have materialized on the Net in fleets.

HMO
A Health Maintenance Organization is a system available to an enrolled group of people in a specific geographic area. Members pay a monthly fee for specific benefits, and select a primary provider when they enroll.
 
A growing number of Web sites allow consumers and employers to shop for health benefits, research doctors, and handle transactions with their HMOs online. For health care companies, it's an opportunity to appease complaints of poor service to their more than 100 million customers in the United States.

"We're there to help the consumer get information and do comparative shopping. That makes us attractive to insurance companies because they want to be where the consumers are," said Jack Meler, president of life and health sales for InsWeb.

Funded by the companies listed with InsWeb, the site offers consumers insurance quotes and application requests from Blue Cross and Blue Shield of New Jersey, Matrix Benefits, and ITT Hartford.

This spring, InsWeb will relaunch its site with a service that will generate custom reports online, tailored to people's specific needs and price ranges.

But InsWeb faces some tough competition, as it is only one of many health service companies that have sprouted on the Web in the last year. Others include:

  Healtheon, founded by Netscape Communications cofounder Jim Clark, links health plans, employers, and care providers. It automates the enrollment and management health plans; lets employees evaluate costs and payment options before they enroll in specific benefit plans; and is offering providers software to bill online. Blue Cross Blue Shield of Massachusetts, its first major client, enrolled last summer.

PPO
A preferred provider organization represents a group of hospitals and/or physicians and contracts with insurance companies, employers, or third parties to provide fee-based care. Members select a primary provider when they enroll but can choose non-network providers.
 
  MedAccess provides a health care locator so that visitors can learn about the costs, locations, and services of their physicians, hospitals, and HMOs. A searchable database for preferred provider organizations (PPOs) is under construction.

  Aetna and U.S. Healthcare have a searchable database of types of care providers in its network, organized by zip code. Using the Web site, customers can add, change, or remove their primary care physician, gynecologist, or dentist; receive new member identification cards; change their pharmacy, or apply for new member ID cards at any time.

Overall, the booming online health services market could cuts costs by $15 billion per year, according to research firm Jupiter Communications.

"HMOs are currently making all the money in medicine," Jupiter analyst Patrick Keane said. "They can easily extend that to the online world."

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