Dealing with Health Insurance Companies, Hospitals and Doctors
Part 1: The Basic Tools, Chapter 1: The Health Insurance Maze Page 6
Continued from Previous Page
According to a study by Thomas Edison College and the New Jersey Institute of Technology, the basis for the development of an efficient computerized, electronic claim-filing and processing system already exists (See Appendix B). Many doctors' offices, hospitals, pharmacies, and insurance companies are already computerized, and a variety of electronic recording systems -- charge cards, debit cards, and electronic cards that can store vast amounts of information -- are currently available.
Similar types of computerized, electronic systems are already in place in other fields. For example, you can now pay by credit card for food or clothing in almost any large store or supermarket in the United States without filling out complicated forms or answering personal questions, and without waiting hours or days for approval. In fact, the process generally requires only a few moments. You can go to any bank's auto mated teller machine, as well, insert your electronic card, and withdraw cash in just a few seconds.
In contrast, when you go to a doctor, a hospital, or a medical testing center you may have to present your health insurance identification card, answer complicated questions about your insurance policy, and provide the insurance company's address, your identification number, and personal medical in formation. In addition, you must fill out and sign a variety of forms.
When you get home, you may need to fill out claim forms, photocopy the medical bill, mail the forms, and record information about the doctor's visit so that you can make certain that the claim is processed properly. You then have to wait several weeks for a response from your insurer. If you're covered by a secondary insurance policy, you'll have to photocopy the Explanation of Benefits Statement from your primary insurer and the bill from the doctor, send those to the secondary insurer, and wait another few weeks for the secondary insurer to process the claim.
Since billions of health insurance claims are filed in the United States, that process is repeated over and over again. The amount of paper used in the current system of health insurance claim-filing and processing, and the amount of time involved for consumers, medical professionals, and insurers is almost incalculable.
Continued on Next Page
