November 2002 • Volume 8 • Number 11 |
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HIPAA is analogous to eating spinach -- it's not something you get excited about," said David C. Kibbe, M.D., in his Oct. 16 Scientific Assembly presentation, "Pathways to HIPAA for Medical Practices: What You Need to Know."
Kibbe, director of health information technology at the AAFP, is a HIPAA expert -- and he knows that the Health Insurance Portability and Accountability Act is serious business to doctors. "After Oct. 16, 2003, Medicare won't accept paper claims, and so if you want to get paid, you need to know a little about this," Kibbe told a packed house.
The first few minutes of the presentation were devoted to HIPAA's history, as Kibbe defined terms and cleared up misconceptions. Avoiding HIPAA by forgoing technology in your practice is one commonly misunderstood area. "Going strictly paper won't help if you have any outside agents that transmit any of your data electronically," said Kibbe.
Kibbe was eager to pump physicians up about the plus side of the HIPAA standards. "The Transactions and Code Sets Standards are the largest computer conversion exercise in the history of the world," said Kibbe. "It's in the best interest of everyone to go 100 percent electronic."
Then he explained why.
Implementing the standards could save you money, said Kibbe, explaining that it currently costs the health care industry 300 to 500 times more than the banking industry to electronically transact a file. "Physicians pay for that because the insurance companies pick up the high transaction costs -- and then turn around and pay you less," he said.
The uniform standards that HIPAA will bring mean physicians will be able to transmit information more efficiently and less expensively, Kibbe added.
Kibbe said HIPAA has the potential to give providers a tremendous amount of power. "You'll be able to send tomorrow's patients' eligibility requirements to the payer today," said Kibbe. "So when the patient comes into your office tomorrow, you'll already know what the payer will cover and you'll already know the co-pay."
Just imagine this, continued Kibbe. When the standards are fully implemented, health plans must respond to physicians' requests for information in real time -- 60 seconds or less.
A murmur passed through the audience.
There's more good news, insisted Kibbe. Electronic transactions will ensure cleaner claims and fewer rejections. Currently, Kibbe said, 5 percent to 10 percent of claims are rejected by the payer because of data entry errors. Electronic transactions should cut that number considerably.
Kibbe covered the HIPAA privacy rule last, and he answered question after question with calm reassurance. He eased physicians' fears about "HIPAA police," presumably out searching for doctors not in compliance.
He closed by describing a new health care world, "where patients are going to understand their rights."
The media will play this issue up big, predicted Kibbe. "I think patients will be coming in and asking, 'Where is your privacy form?' -- because Connie Chung will be talking about this, and Oprah will be talking about this," he said.
FP Report is published by the
AAFP News Department.
Copyright © 2002 by
American Academy of Family Physicians.