Doug, why can't Susan file the claim? The patient surely knows her own SSN, so leave off the member ID on the Subscriber NM1, and include a secondary reference to the SSN. Can't insurance companies find out which subscriber (or patient) is being referred to solely by the name and the SSN? They have computers, don't they? Why put the patient in the middle of this?
William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ----- Original Message ----- From: "Doug Webb" <[EMAIL PROTECTED]> To: "WEDI SNIP Transactions Workgroup List" <[EMAIL PROTECTED]> Sent: Friday, 19 September, 2003 10:04 AM 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] "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 To: WEDI SNIP Transactions Workgroup List 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 --- 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
