 Oct. 18, 2002 |
| ASSEMBLY EDITION • SAN DIEGO |
Many physicians have been reluctant to jump onto the Health Insurance Portability and Accountability Act bandwagon. But on Wednesday, hundreds of FPs suddenly appeared eager to learn everything they could about complying with this federal legislation.
The lecture hall was packed for the presentation by David C. Kibbe, M.D., "Pathways to HIPAA for Medical Practices: What You Need to Know."
In fact, when all the seats were taken, folks sat on the floor, leaning against every inch of available wall space.
Kibbe, director of health information technology at the AAFP, is a HIPAA expert. He understands the fear and frustration physicians feel about government-imposed regulations. So he opened his seminar with humor by saying, "HIPAA is analogous to eating spinach -- it's not something you get excited about."
But HIPAA is serious business. "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," said Kibbe.
The first minutes were spent giving HIPAA's history, defining terms and clearing up misconceptions. "There is an urban legend going around that you can opt out of HIPAA by going completely paper in your office," said Kibbe. "Not true ... going paper won't help if you have any agents that transmit any of your data electronically."
Kibbe was eager to get his fellow physicians as excited as he is 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.
And uniform standards will enable physicians 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 -- 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. (This piece of information caused a stir in the audience.)
And electronic transactions will ensure cleaner claims and fewer rejections. Currently, said Kibbe, 5 percent to 10 percent of claims are rejected by the payer because of data entry errors. Electronic transactions should drop 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.
Then he talked about a new world, "where patients are going to understand their rights."
"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
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Copyright © 2002 by
American Academy of Family Physicians.