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Hungry Hungry HIPAAs

Jan. 1, 2003
HIPAA, also known as the Administrative Simplification Act, was designed to reduce the astronomical costs associated with the transfer of insurance and payment data related to health-care procedures.

by Joseph Epstein

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HIPAA, also known as the Administrative Simplification Act, was designed to reduce the astronomical costs associated with the transfer of insurance and payment data related to health-care procedures. HIPAA establishes a standard for electronic data transactions. By meeting these standards, you will be able to send information in more private, secure, and cost-efficient means.

Recently, a business friend, Dean Greenblatt, a computer engineer who created HIPAA-compliant, practice-management software, made a very good analogy between the savings HIPAA will generate and the probable resulting effects. He reminded me of the children's game, Hungry Hungry HipposTM. The analogy is much more than just a clever play on words. Do you remember how the game works? The basic description of this game is, "A frantic marble-grabbing action game. All the hippos are hungry and want to gobble up as many of the marbles as possible."

HIPAA will generate savings for the health-care industry, but does your practice know how you can garner some of these marbles? If you don't take immediate action, the health-plan providers (insurance companies) and the health- plan clearinghouses (claims-submission companies) will gobble up these savings, leaving you empty handed and without HIPAA benefits.

Further clarification of the hippo metaphor will give you a clearer picture. The marbles equate into savings generated through HIPAA implementation. Currently, there are three hippos playing for these marbles:

The health-plan providers are potentially the biggest benefactors of the HIPAA implementation, due to a large reduction in clerical tasks. They are the ones who will most likely gobble up the greatest share of the marbles. They are the pink hippopotamus.

The health-plan clearinghouses are the middle men that you pay to submit electronic claims. Currently, the clearinghouses charge for each claim they process (a sneaky way to get your marbles!).They are the yellow hippopotamus.

You are the health-care provider. You are at a disadvantage because you have not been properly informed about HIPAA. Right now, you are the sad, blue hippo. If you are ready and willing to act soon, you will become the profitable green hippo.

The deadline for HIPAA compliance is rapidly approaching, and an extension is actually a short-term problem to the solution. Soon, your office will have the ability to streamline electronic-data transfers and automate many clerical procedures. Wasted time filling in forms and updating patient records will be reduced to the extent that they won't even be tasks in the office, much less a burden. You won't even have to rely on peripheral software to estimate patient benefits. The actual policy benefit amounts can reach your practice as soon as you make the request. Your office will save time without having to pay for many services that you currently view as reasonable costs.

Your practice can acquire some marbles just knowing that the game has started. Your first step toward getting the marbles is to get your hippo chomping! This means making sure that your software will provide new HIPAA-related features that will reduce administrative paperwork in your office. The next objective is to find ways that enable your practice to send claims without middle men, especially ones that charge you to do so. Also, don't let third-party software vendors steal your marbles, promising ridiculous services and products like HIPAA-compliant email for a fee. Companies like these are just confusing you with unnecessary products and making you lose your marbles! Be wary of anyone selling anything HIPAA-related — even your current software company! If you want more information on how to start reaping these savings, contact Dean Greenblatt ([email protected]). There is a smart, simple, and elegant solution to working within HIPAA that saves you time and money. So, now that you know there are marbles to be had, be a Hungry Hungry Hippo!

Editor's Note: For more information on HIPAA, visit, and learn about ways that your office can benefit from HIPAA. To read the actual Health Insurance Portability and Accountability Act, visit HIPAA (Public Law104-191 available at simp/pl104191.htm).

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