> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] > > I'm not sure what John has in mind for future benefits, but > one of the > impacts the legislation has had to date is on healthcare > "portability". If you move > from one employer to another you can no longer be denied care or have > "preexisting conditions" that can lead to denial of care for > a year (or more).
The portability part of HIPAA has been in place for a long time. What is being put in place now is part of the act called "Administration Simplification". This was originally designed to force the healthcare community to use standard formats when trading EDI (claims, enrollment, payment, etc). The privacy piece was added when folks started to get scared about having all this information floating around in an electronic format. Then a security piece was added on as well. Generally, I think the security piece (which won't be enforced until 2004, I believe), is a very good set of rules. I think many healthcare organizations didn't realize how open to attack they were/are. For example, I'm on a HIPAA mailing list where people regularly ask if putting a password on a ZIP file they are sending over the Internet is good enough "encryption". (It's not.) The privacy piece I am more neutral about. I truly believe our medical information is now more secure from prying eyes than before. This does come at a cost. Added complexity and procedures both for doctors and for health plans. The big (potential) return is on the EDI transactions side. (This takes effect October 16th.) We, as a health plan, currently receive electronic claims in several different formats all with slightly different twists. We also require providers to bill in a certain way. HIPAA says that we have to use the ANSI standard 837 format for electronic claims and there is a 750 page guide that explains how to implement it. We won't be able to force providers to use certain codes anymore. Which simplifies things for them. We won't have to maintain multiple formats for different trading partners, which simplifies things for us. Once the standard health plan and national provider numbers are in place, matching an electronic claim to our provider database will be greatly simplified and improved, decreasing our costs. Health Plans will return payment information to the doctors using a standard format which should allow them to auto-post the payment information into their billing systems, which is completely a manual process right now. And doctors can receive payment via EFT which decreases the payment cycle. We're still probably a few years away from really seeing a return. The kinks in the system need to be worked out. The various billing systems doctor's use need to be updated to be more fully automated. The "wiggle room" in the various formats need to be worked out amongst trading partners. But there will be increased efficiencies all around. I've spent the last few years hip deep in HIPAA at my company. I curse it regularly, believe me. But it certainly isn't as bad for the end healthcare consumer as that article would lead you to believe! - jmh Off the Soapbox Maru _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
