IDing people is not always that
easy. Cell phones have made telephone numbers a commodity and I know
personally I have to try to remember if I used a cell phone number or land line
number as an ‘ID’ with a service provider. Without a true
national id (which will never happen) IDing people will always be a challenge.
Regards,
David Frenkel
612-237-1966
-----Original Message-----
From: Mike Urban
[mailto:[EMAIL PROTECTED]
Sent: Monday,
September 22, 2003 1:35 PM
To: WEDI SNIP Transactions Workgroup
List
Subject: RE: Insurance cards with
no Insured ID
A health plan simply
needs enough information to positively identify the subscriber or
dependent (e.g., name and phone number). If a system's lookup capability
is limited to subscriber/member ID, it is a limitation of that system, not
a logical requirement for *any* system.
-----Original
Message-----
From: C. Campbell
[mailto:[EMAIL PROTECTED]
Sent: Monday,
September 22, 2003 11:18 AM
To: WEDI SNIP Transactions
Workgroup List
Subject: Fw: Insurance cards with
no Insured ID
When calling to verify benefits an ID # is
required. How else will the Health Plan be able to identify the insured
and give benefits? So some type of ID # will be required.
----- Original Message -----
Sent: Friday, September
19, 2003 9:48 AM
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]>
>
> "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
>
>
> ---
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