Doctors warned about October's HIPAA deadline

Experts say contingency plans are needed so that payment is not severely disrupted by new electronic transaction standards.

By Joel B. Finkelstein, AMNews staff. May 19, 2003.

Washington -- Five months may seem far off, but industry watchers are warning doctors that they are running out of time to ensure that Medicare and insurance companies will accept their bills after the Oct. 16 deadline for switching to standardized electronic claims.

The change is required under the Health Insurance Portability and Accountability Act of 1996.

"The industry has been so focused on compliance with the privacy rule that transactions have been put on the back burner," said Robert Tenant, government affairs manager for the Medical Group Management Assn.

Another problem has been that physicians are largely reliant on their software vendors to supply them with upgrades before they can even begin testing the new electronic claims procedures. Some national vendors have been slow to develop compliant software in part because the federal government took so long to come out with a final rule, Tenant said.

Experts have been urging doctors to become more proactive in calling and questioning vendors. Practices need to find out if vendors will be ready soon, and if not, physicians need to start shopping for new ones, they advise.

"I have been disappointed to see that physicians have not taken this to heart," said Jeffery Hausfeld, MD, a practicing physician and CEO of HIPAA Innovations in Bethesda, Md., a company that offers HIPAA compliance products.

Physicians have been falling prey to "HIPAA hysteria." They are overwhelmed by what seems like a never-ending task, he said. But working with their software vendors, doctors can be ready in time, Dr. Hausfeld added.