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BUSINESSInsurance sites limit ability to submit online claimsA survey cites federal HIPAA regulations as a reason why insurers increasingly are taking claims and referral authorizations offline.By Tyler Chin, AMNews staff. Dec. 9, 2002. During the next few months, physicians may find themselves unable to transmit claims and verify referral authorization status through insurers' Web sites as insurers take those services offline to make them compliant with new federal standards for electronic health care transactions, according to Cap Gemini Ernst & Young. The New York health care consulting company, which surveys and assesses the online interactive capabilities of insurers' Web sites every six months, found insurers have significantly improved the interactive capabilities of their sites but have also curtailed the ability of physicians to submit claims and check referral authorization status. About 53% of insurers surveyed let physicians submit claims through their Web sites in March, but only 44% did so in October, according to Cap Gemini. The survey also found a slight decrease in the proportion of insurers letting doctors check referral authorization status online, down from 58% to 56%. Insurers are pulling those transactions off their sites because they need to revamp them to meet the requirements of the Health Insurance Portability and Accountability Act, said Peter Kongstvedt, MD, a vice president at Cap Gemini and co-author of the firm's report. Under HIPAA, physicians, insurers, providers and claims clearinghouses must use standardized national formats for claims and several other claims-related transactions by Oct. 16, 2003, if they had applied for a one-year extension. Otherwise, they had to comply with the regulation as of Oct. 16 of this year. In any event, the law requires covered parties to start testing the transactions in April. [...] Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2002 American Medical Association. All rights reserved.
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