Physicians report glitches with HIPAA-compliant claims

Doctors in Connecticut and California said a computer system failed to deliver claims, leaving them with cash-flow problems.

By Tyler Chin, AMNews staff. Nov. 17, 2003.

Physicians in at least two states have reported difficulty submitting HIPAA-compliant claims electronically to major insurers.

Two California physicians, one of whom was forced to take a line of credit to cover payroll, said their claims clearinghouse and physician practice management software vendor, WebMD Corp., failed to deliver claims to insurers. Karen Nikos, a spokeswoman for the California Medical Assn., declined to identify the physicians, but said CMA is assisting them.

In Connecticut, a third of the 300 physicians in Middlesex Professional Services Inc., an independent practice association in Middletown, had problems submitting claims through WebMD to Anthem Blue Cross and Blue Shield and Medicare, said Doug Arnold, the IPA's executive director.

The Connecticut State Medical Society said that as of late October, the Middlesex Professional Services complaint was the only one it had received. Other state medical societies had not reported any complaints.

Elmwood Park, N.J.-based WebMD said it was aware of problems only in Connecticut. "There may be isolated incidences where there are communication errors, coding errors or other reasons for a delay, but overall we're not seeing delays at a national level," said Jennifer Meyer, a WebMD spokeswoman.

"We have done HIPAA transition with thousands of customers who are sending claims in a HIPAA format who have had a wonderful experience and have had no problems at all," added Sabrina Dobbins, vice president of business development for WebMD Practice Services, formerly Medical Manager Health Systems Inc., the physician practice management software unit of WebMD.