Health care's paper tiger

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As they say, the Devil is in the details.: I'm a psychologist in practice on my own, and am bound by HIPAA. Here's a few additional problems:

1) HIPAA reads like the Torah. There's statements, comments on the statements, replies to the comments, and notice of changes or refusals to make changes based on them...

2) Because of the scalability aspect of it, I'm not required to do the same things as a large hospital, but there is little clarity on what I *am* required to do. The HHS website has over 200 "frequently" asked questions addressing what is *likely* required, but there's been no interpretation by courts as to what some phrases and requirements mean.

3) Have you ever filed insurance claims? I spent four hours with BC/BS trying to clear up a single client's paper claims for nine hours of services, and everybody had a different reason for why it was screwed up, and why I definitely had to speak to some other department. I could never talk to someone who knew what was going on or would simply investigate and find out. Going electronic scares me because 1) I have no exact copy of what was sent to the insurance company, and 2) it's only going to get more difficult to find anybody accountable for an error if we all go electronic.

4) The article did note that most of the complaints received have been about *billing companies* and not providers. I've been told by insiders that they can not recommend *any* billing company in good conscience, and I've been burned by the last two I used. I reported them to HHS, and received a letter saying that HHS was looking into whether or not they had the jurisdiction to do anything. That was three months ago and I've heard nothing.

In short, I don't have time as a single provider to spend one third of my time trying to get paid for two thirds of my time at reduced insurance rates AND to learn new software packages and practices, AND start outsourcing my billing. There is no "HIPAA Hotline" or any other definitive source for information either. While the healthcare industry may be making millions of dollars, I'm not.

Richard Niolon, Ph.D.; Posted by: niolonra Posted on: 02/26/04 You are currently: a Guest | Members login | Terms of Use