Published in AAPI Journal, May – 2004 by Dr. Hassan Mohaideen
Physicians and their office staff are tired of calling insurance companies to inquire about the status of their claims. They often spend endless hours on phone calls, only to be told that the “claim is being processed” or the “check is in the mail”. Busy surgeons or procedure oriented practitioners call and go through a long process to obtain authorization for procedures – many practices requiring additional staff for, this purpose. In addition, different health plans utilize different codes – for anything from procedures to reasons for denials and changes in reimbursement. Each plan also assigns a different ID number to a participating provider. Now, under the Health Insurance Portability and Accountability Act (HIPAA) rules, a single coding system must be used by all healthcare payers.