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Valata,
Your posting didn't. The response Susan quoted in the
original post DID.
The CSR had no clue as to how to obtain the necessary
ID.
The Patient had no idea what the necessary ID
was.
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 -----
Sent: Monday, September 22, 2003 11:55
AM
Subject: RE: Insurance cards with no
Insured ID
I do not believe that my posting blames anything on HIPAA or
the state laws
for that matter. The entire purpose of my referencing
the state laws in my
response was to offer some explanation for why the
social security numbers
are being removed from ID cards and maybe the CSR
was misinformed. Nor does
my response imply that because the use of
social security numbers are
prohibited that insurers couldn't assign a
unique identifier to the insured.
Rachel you are correct, "this legislation
was not passed overnight in the
blink of an eye" however you should also
note that although the effective
date of the law is July 2002 the actual
compliance date varies with
different circumstances. Nor was I
offering excuses for these insurers.
However this isn't even the
point.
I was trying to point out a possible solution to the poster on
how to get
the information she needed to submit claims. Taking an
adversarial approach
as was suggested rarely solves anything. To use
your word Rachel I am
nauseated. Nauseated by the constant suggestions that
the insurance industry
is always trying to find ways to place "new barriers
to doing business and
providing appropriate customer service." As I
stated in my earlier email I
have been in this business a long time and
have never worked for any insurer
that had as its goal to provide "crappy"
customer service. As a
matter-of-fact the companies I have been
associated with have all made
customer service a top priority. To
imply such is an insult to those of us
in this industry that strive on a
daily basis to provide superior customer
service.
Maybe, just
maybe, the customer service representatives were not
properly
trained. By contacting the supervisor or claim manager the
provider office
could obtain the information they needed and help the
insurer appropriately
train the CSR so that they do not provide "crappy"
customer service in the
future.
> -----Original
Message-----
> From: Doug Webb [SMTP:[EMAIL PROTECTED]
> Sent:
Monday, September 22, 2003 9:00 AM
> To: WEDI SNIP Transactions
Workgroup List
> Subject: Re: Insurance cards with no Insured ID
>
> Amen, Rachel!
> A restrictive business practice is just that --
a restrictive BUSINESS
> PRACTICE.
> To blame such obstructions on
HIPAA is just plain lying.
>
> 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: Rachel Foerster
<mailto:[EMAIL PROTECTED]>
> To: WEDI SNIP Transactions Workgroup List
> <mailto:[EMAIL PROTECTED]>
> Sent: Saturday, September 20, 2003 03:23 PM
> Subject: RE:
Insurance cards with no Insured ID
>
> Valeta, simply because
California (and perhaps other states) have passed
> legislation
prohibiting the use of the SSN doesn't mean that an insurance
> company
can't assign some other unique identifier to each insured. Using
> this
legislation as a basis for not assigning an insured identifier is
>
also
> bogus.
>
> This legislation wasn't passed overnight
in the blink of an eye. Insurers
> knew this was coming for months if
not longer. They've had ample time to
> prepare for using/assigning
other insured identifiers and providing those
> insureds with insurance
cards with appropriate information so that claims
> can be submitted.
It's irrelevant whether it's the provider or the insured
> submitting
the claim; either party must know the insured's identifier to
>
do
> so.
>
> This is just plain bogus and crap! I am so
nauseus of covered entities
> hiding behind HIPAA to place new barriers
to doing business and providing
> appropriate customer service.
>
> Rachel
> Rachel Foerster
> Chief Executive
Officer
> Rachel Foerster & Associates, Ltd.
> Ideas -
Products - Innovation
> 39432 North Avenue
> Beach Park, IL
60099
> Voice: 847-872-8070
> email: [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]>
>
<http://www.rfa-edi.com>
>
>
> -----Original Message-----
> From: Valeta Barger
[mailto:[EMAIL PROTECTED]
> Sent: Friday, September 19, 2003
9:48 AM
> To: WEDI SNIP Transactions Workgroup List
> Subject: RE:
Insurance cards with no Insured ID
>
>
> 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]>
> > <
<mailto:[EMAIL PROTECTED]>>
>
>
> > ----- 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
>
>
>
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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
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These listservs should not be used for commercial marketing purposes or
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