Doug, I agree that blaming HIPAA is bogus, however California passed legislation, I believe in July 2002, that prohibits the use of social security numbers on correspondence, including insurance ID cards. Since most, not all, insurers have traditionally used the SS# as the ID number this has required a massive change in business for insurers. You should also note that Utah has also passed similar legislation. I agree the response from the insurer is unacceptable. I would contact the claim manager at the payer to obtain the needed information and report the incompetent employee that provided the answer. I also think some of the responsibility falls upon the patient (consumer). If the consumer wishes the provider to bill their insurance company on their behalf the consumer most certainly should ensure that they can supply the needed information to the provider. It is inconceivable to me that any consumer would purchase a product that requires ID numbers in order to use the product and not demand this information from the company. That's like obtaining a credit card but not being provided the number so that you can utilize the card. Also after having worked in the insurance industry for 20 years I find that this business is just like any other business. There are good and bad companies that employee good and bad staff. It has been my experience that most insurers wouldn't respond with "You can't do that!" but if approached would work to correct the problem.
> -----Original Message----- > From: Doug Webb [SMTP:[EMAIL PROTECTED] > Sent: Friday, September 19, 2003 10:05 AM > To: WEDI SNIP Transactions Workgroup List > Subject: Re: Insurance cards with no Insured ID > > Susan, > 1) Blaming HIPAA for this fiasco is totally bogus. > > 2) "I dunno" is a totally unacceptable response from the insurance > company. > > 3) If you can't get a vaild insurance ID, you can't file a claim. A 270 > query MAY reval the proper information. You shouldn't have to do so to > get a valid ID. Bill the patient. Inform the the insurance company that > you will do this, and will give the patient X days to pay before being > referred to your collector. The insurance company will probably respond > "You can't do that!"; you can respond "We can and will if you don't clean > up your act!" > > The opinions expressed here are my own and not necessarily the opinion of > LCMH. > > Douglas M. Webb > Computer System Engineer > Little Company of Mary Hospital & Health Care Centers > [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> > > "This electronic message may contain information that is confidential > and/or legally privileged. It is intended only for the use of the > individual(s) and entity(s) named as recipients in the message. If you > are not an intended recipient of the message, please notify the sender > immediately, delete the material from any computer, do not deliver, > distribute, or copy this message, and do not disclose its contents or take > action in reliance on the information it contains. Thank you." > > > > > ----- Original Message ----- > From: Susan Hollabaugh <mailto:[EMAIL PROTECTED]> > To: WEDI SNIP Transactions Workgroup List > <mailto:[EMAIL PROTECTED]> > Sent: Friday, September 19, 2003 07:17 AM > Subject: Insurance cards with no Insured ID > > We have begun receive patients in our California Imaging Centers who > present > Insurance cards with no Insured ID. > > Here is the experience as reported from our Director in the region: > > "One Health Plan and Aetna are issuing new insurance cards without the > Insurance Identification Number. I called both insurances to ask why, and > was told, "HIPAA". Both are in the process of issuing new cards to ALL > members > > So I asked, the patient, "what is your Insurance ID number?". "I dunno" , > was the answer > > So I asked the insurance companies, "are we to assume that the ID number > is > the social security number?" "I dunno" , was the answer. They would not > provide me with the ID number." > > How are we going to bill a patient's insurance company under these > circumstances? How are others dealing with this situation? Will this > necessitate Eligibility verification? Could we find the information that > we > need that way? If this extends throughout the market, it will be a > nightmare > for providers. > > EDI Project Manager > 8754 Dunstable Loop > Bristow, VA 20136 > (703) 369-5775 > > > --- > The WEDI SNIP listserv to which you are subscribed is not moderated. The > discussions on this listserv therefore represent the views of the > individual participants, and do not necessarily represent the views of the > WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official > opinion, post your question to the WEDI SNIP Issues Database at > <http://snip.wedi.org/tracking/>. These listservs should not be used for > commercial marketing purposes or discussion of specific vendor products > and services. They also are not intended to be used as a forum for > personal disagreements or unprofessional communication at any time. > > You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] > <mailto:[EMAIL PROTECTED]> > To unsubscribe from this list, go to the Subscribe/Unsubscribe form at > <http://subscribe.wedi.org> or send a blank email to > [EMAIL PROTECTED] > <mailto:[EMAIL PROTECTED]> > If you need to unsubscribe but your current email address is not the same > as the address subscribed to the list, please use the > Subscribe/Unsubscribe form at <http://subscribe.wedi.org> > > --- > The WEDI SNIP listserv to which you are subscribed is not moderated. The > discussions on this listserv therefore represent the views of the > individual participants, and do not necessarily represent the views of the > WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official > opinion, post your question to the WEDI SNIP Issues Database at > http://snip.wedi.org/tracking/. These listservs should not be used for > commercial marketing purposes or discussion of specific vendor products > and services. They also are not intended to be used as a forum for > personal disagreements or unprofessional communication at any time. > > You are currently subscribed to wedi-transactions as: > [EMAIL PROTECTED] > To unsubscribe from this list, go to the Subscribe/Unsubscribe form at > http://subscribe.wedi.org or send a blank email to > [EMAIL PROTECTED] > If you need to unsubscribe but your current email address is not the same > as the address subscribed to the list, please use the > Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
