Fw: Insurance cards with no Insured ID

[C. Campbell]

Most Provider offices do ask to see you health ID card, since patients are notoriously bad about notifying offices about changes in group numbers or health plans. ----- Original Message ----- From: Mike Urban To: WEDI SNIP Transactions Workgroup List Sent: Friday, September 19, 2003 10:30 AM Subject: RE: Insurance cards with no Insured ID The scenario seems to imply that the "claim filing system" does not have the patient info already in it... ER visit, for example. Why else would they be asking for their insurance card? If you are seeing your managed care PCP, for example, you are probably in their system, and most places of service don't need to see your insurance card for each visit... In those cases, name and some sort of "tie breaker" (address, phone #, ssn, etc.) should be all that are needed to find the correct patient in the system. > -----Original Message----- > From: William J. Kammerer [mailto:[EMAIL PROTECTED] > Sent: Friday, September 19, 2003 10:03 AM > To: WEDI SNIP Transactions Workgroup List > Subject: Re: Insurance cards with no Insured ID > > > 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 > --- 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