Healthcare Administrative Simplification Coalition encourages standardization of patient health insurance identification cards

WASHINGTON, D.C., May 12, 2006 - To date, health care providers, health plans or payers, government programs and others have issued more than 100 million health
identification cards to patients. The Healthcare Administrative Simplification Coalition (HASC), a public/private partnership of organizations committed to reducing the administrative costs and complexity of health care, today announced its support for efforts by the Workgroup on Electronic Data Interchange (WEDI) to bring greater uniformity to the information, appearance and technology of those patient ID cards.

WEDI is working to develop guidelines to implement ID card standards that have been previously developed by the American National Standards Institute. "Machine-reading a patient ID card can cut identification errors, reduce costs due to rejected claims, decrease admission processing time and contribute to more streamlined business procedures," said Linda L. Kloss, MA, RHIA, CEO of the American Health Information Management Association, a HASC member. Because technology is advancing rapidly, WEDI must ensure that its guidelines offer sufficient flexibility to address future capabilities, as well as meet the needs of particular payers and employers.

A case study for the potential benefits of greater standardization is offered by Kansas City's Mid-America Coalition on Health Care. The Mid-America Coalition, comprising employers, health plans, hospitals and medical practices, found that many patient ID cards could not be easily photocopied or did not contain all the necessary information for submitting an accurate insurance claim. As a result, providers submitted a significant number of health insurance claims that contained incomplete or inaccurate patient information, leading to avoidable rejections. These claims rejections produced significant added administrative costs for physicians, hospitals and health plans.

Therefore, the Mid-America Coalition developed voluntary guidelines for standardizing paper-based patient ID cards. Because these guidelines are voluntary, they maintain the flexibility that health plans and employers need to meet specific accounts' needs. Recognizing that all stakeholders have a role, the coalition also developed "best practices" for employers providing medical benefits and for medical offices, including the identification of effective work flow processes. Most health plans in the Kansas City market now use these guidelines, reducing administrative waste and complexity and the costs associated for providers, payers and employers.

"The Mid-America project is a great example of a local initiative that reduced costs for all the parties in the health care system, said Douglas E. Henley, MD, FAAFP, executive vice president of the American Academy of Family Physicians, a member of HASC.

HASC estimates that as much as $300 billion a year is consumed by duplicative or unnecessarily complex administrative activities in health care. "We hope others in the industry will strive to emulate WEDI and the Mid-America Coalition in working together to find other opportunities to eliminate unnecessary administrative complexity," said William F. Jessee, MD, FACMPE, president and CEO of the Medical Group Management Association, a member of HASC. "When processes are simplified and standardized, the entire industry stands to benefit."

Find more information on the Kansas City ID card project on the Mid-America Coalition on Health Care Web site, www.machc.org. Information on WEDI is at www.wedi.org.

 

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Founded in 1947, the AAFP represents more than 93,000 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Nearly one in four of all office visits are made to family physicians. That is 215 million office visits each year - nearly 48 million more than the next medical specialty. Today, family physicians provide the majority of care for America's underserved and rural populations.

In the increasingly fragmented world of health care where many medical specialties limit their practice to a particular organ, disease, age or sex, family physicians are dedicated to treating the whole person across the full spectrum of ages. Family medicine's cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

To learn more about the American Academy of Family Physicians and about the specialty of family medicine, please visit

www.aafp.org.

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