Re: Insurance cards with no Insured ID

[Ken Steen]

The California law does not prohibit ID numbers on  cards.  It is aimed at the SSN and "identity theft".  As of July, 2002, companies cannot send any paper to any resident of California with their SSN included in the paperwork.  As usual, there are a number of exceptions, such as DMV, IRS, etc.  Also, healthcare was given an extra amount of time to comply.   The law does allow individuals to submit the SSN as a part of a form.  It is only that whick is mailed to the individual.   Absolutly nothing prohibits establishment of a cross reference between another ID number and SSN.   Ken Steen California resident   ----- Original Message ----- From: Doug Webb To: WEDI SNIP Transactions Workgroup List Sent: Friday, September 19, 2003 12:49 PM Subject: Re: Insurance cards with no Insured ID William, I wouldn't have suggested the bill the patient option if the customer rep had come up with any kind of positive response.   Actually, the response "Ask the patient for the SSN" would almost work.  BUT, what do you do if the patient is unable to respond?   Try this on for size:   Keep the SSN as the ID Put an encrypted version of the SSN on the card [think about using Digitial Certificate technology] Make the decryption algorithm and key available to properly-identified providers [establish a Provider log-in to a Web site that the Digital Certificate could be fetched from] Once any provider has the ID in its billing system, it shouldn't have to refer to the card again.    [OR - have the encrypted version be what's sent, and decrypt it on receipt, recrypting it before sending responses -- this would be a little more secure, and might be easier on the providers]   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: William Openshaw To: 'Doug Webb' ; WEDI SNIP Transactions Workgroup List Sent: Friday, September 19, 2003 01:41 PM Subject: RE: Insurance cards with no Insured ID Doug,   As a human being who often has health problems which require a visit to my doctor, I can understand the frustration that will exist with an Identification Card that doesn't provide the proper identification.  The problem is most payers use the members SSN as their Policy #, or Member ID.   But as a payer, you have to realize that state law may not permit us to send information that contains the SSN.  Also HIPAA may require us to de-identify our correspondence to certain individuals or entities, which causes problems in properly identifying the individual.  We are currently in the process of removing the SSN from our ID cards, and I personally think that this will cause a relatively large amount of confusion.  Like one reply mentioned, when seeing your normal physician, they should already have this information on file, therefore it's a non-issue, but for visits to the emergency room, or referrals to specialty doctors, the ID cards that are presented at the time of visit will be inadequate to properly bill the insurance company.  The option of the physician's office calling the payer to obtain this information is also, IMHO, another unnecessary step enforced upon the provider community by these laws that are preempted to protect the rights and information of the patient.  Regardless if the provider reaches a competent Customer Service Rep at the payer office.  If that answer were given by one of our analysts, rest assured that it is unacceptable and disciplinary action would most certainly be explored.  I'm speaking for my company, and can't vouch for any other payers, but I pray that they would also agree.   So the problem here is that we all have to deal with the new laws and regulations that are being demanded of the Health Insurance industry, regardless which avenue you and your company do business on.  The approach that we all have to take (payers, providers, CH's, health plans, individuals) is to reach a solution that complies with the new demands, but also allows us to operate business on a level as close to "status quo" as possible.  Albeit, assigning each individual a unique ID other than a SSN is a little too much "Big Brother" for most people, we must identify a way to achieve our business goals.  We can do this by either educating the member community that when asked for their ID Number, they must give the policy holders SSN, or by providing the Provider community a unique way to identify members.  Simply taking the stance that we will just bill the patient and let them deal with the payer is somewhat of a "copout", and will only upset your members.  We all know that you have a much greater possibility of receiving a timely payment from a payer than trying to fight it out of a patient.  Especially in today's economy.   I don't have the answer.  I wish I did.  Although I am fairly confident that the people associated with this forum will provide great alternatives to most of our problems.  Perhaps not the answers that we are all looking for, but we need to stop pointing fingers and casting blame at each other.  Either we work together or it doesn't work.   -----Original Message----- From: Doug Webb [mailto:[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]   "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 (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] 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 --- 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