If they gave a prize for the industry with the most red tape, healthcare would win hands down. Yet the mass of paperwork continues unabated.
One step that could make life easier for hundreds of thousands of physicians (as well as their patients) is the introduction of a single, universal claim form. Adoption of such a form could make a significant dent in reducing the portion of healthcare expenditures that go to administrative costs, at minimum an estimated 15 percent of the healthcare dollar.
There's no reason why physicians should have to deal with dozens of different insurance forms on a regular basis. A big part of their office assistants' time is devoted to handling the paperwork, taking them away from the important job of patient care and causing serious frustration for clinics.
A simplified form would create major goodwill among physicians who complain constantly about the paperwork hassles with which they must cope. And it would cut the cost of processing claims for the insurers.
Standardization was supposed to get a boost from provisions of the Health Insurance Portability and Accountability Act of 1996 requiring standardized electronic transmission of healthcare data. A working group on insurance claims was set up, but the effort ground to a halt along the way.
Right now, the best chance of success is at the state level. The Utah Health Information Network brought together a coalition of payers, providers, business and government in 1993 to implement the adoption of a common claim form with standardized data fields and definitions. Once the system was adopted, payers could not reject a claim, whether paper or electronic, that had appropriate data in the appropriate box. Virtually all providers and payers in the state are using the system, which is available online.
Such projects require cooperation by providers, insurers and regulators and a realistic game plan. Medical managers would do well to become involved in similar efforts.