HIPAA could help -- really! -- August 2002 -- FP Report

August 2002 • Volume 8 • Number 8

HIPAA could help -- really!

David Kibbe, M.D., director of health information technology in the AAFP Socioeconomics Division, has been on the front line disseminating information about the Health Insurance Portability and Accountability Act for many months. He has fielded questions from concerned physicians around the country. Here's a slice of what he's heard and, more important, the "good news" he wants FPs to consider.

FP Report: As you talk to physicians about HIPAA implementation, what are their top concerns?

Kibbe: I would say the major concern is HIPAA's size and scope. HIPAA seems difficult to grasp, partly because much of the early communication about it has come from lawyers and compliance officers. I see many physicians who despair of ever getting a handle on its provisions in any practical way. "Bring it down to the office level," and "Just tell me how to stay out of trouble," are requests I hear often. If I were in active practice today, trying to run a busy office, I would react the same way.

FP Report: Are these concerns warranted? Are physicians being asked to do the impossible?

Kibbe: Not really. I think HIPAA information standards are manageable, for the most part. What's been missing from most presentations that doctors hear are the benefits HIPAA will bring to their offices. When the standards for electronic transactions and code sets are implemented, it will really take the "crazy" out of the billing and payment hassles we currently endure.

FP Report: Can you spell out key areas where FPs could see significant positive changes -- that proverbial light at the end of the tunnel?

Kibbe: Certainly. The main benefits are these:

Faster payments. Imagine a system with more electronically submitted claims, cleaner claims at submission, automated processing, and fewer rejected and "on hold" claims.
Better cash flow. Determining eligibility data on insured patients at the time of service --or just before -- will improve the accuracy of co-payment and deductible amounts. Authorizations will be delivered in real time.
Shorter accounts-receivable cycles. Claim status will be queried electronically in real time, meaning disputed, denied or delayed payment amounts can be addressed more quickly.
Lower office overhead. Remittances will be posted electronically instead of by hand, with funds transferred directly to the office account.
No more "local codes" to deal with.

I also think that patient-physician relationships might improve if the office and the patient are able to access insurance and claims data at the time of service, clearing up any misunderstandings that may have arisen about the patient's coverage and health plan details.

FP Report | Headlines | AAFP Home | Search