WebMD's response to HIPAA-related complaints
WebMD operates the country's largest electronic transactions clearinghouse in the United States, annually processing more than 2.3 billion transactions for more than 200,000 physicians and 5,000 hospitals with more than 1,200 commercial and government health care payers.
As the industry leader, WebMD has spent millions of dollars and committed thousands of hours in implementing the new HIPAA standards for our customers. Today, we lead the industry in submitting transactions in HIPAA format. More than 75 percent of the transactions WebMD sends to all payers are in HIPAA standard format--well ahead of the rest of the industry.
On a daily basis, we enable tens of thousands of providers to send millions of transactions in HIPAA standard format to payers across the country.
In Mr. Canning's case, it's important to clarify the premise of his accusations. He claims that WebMD "implemented a policy, whereby we would follow the old non-HIPAA rules...without notifying vendors or customers."
WebMD does not have a policy to follow any "old non-HIPAA rules," as Mr. Canning alleges. We believe he's referring to the Centers for Medicare and Medicaid Services' (CMS) Contingency Planning period, which CMS established to allow health plans to accept transactions from providers who have not yet converted to the HIPAA standard.
Many of Mr. Canning's clients and other providers around the country were not able to comply with the Oct. 16, 2003, HIPAA deadline, so WebMD implemented a contingency plan in accordance with CMS guidelines to enable them to continue to submit claims electronically and receive timely payment.
WebMD sent written notification to every customer in the region, outlining this CMS contingency plan. This notice explained to our customers WebMD's use of HIPAA processing rules and edits to translate non-HIPAA transactions to HIPAA-standard transactions, which would assure proper claims adjudication, irrespective of whether the health plan was HIPAA-ready.
The net effect of this decision by WebMD--and the industry as a whole--to implement contingency plans was that health care provider reimbursements were decidedly uninterrupted. We are further puzzled by Mr. Canning's assertions that WebMD has been "slow to respond to questions and attempts to resolve such situations" and that we have experienced "a tremendous amount of turnover."
Over the past several months, our customer service team has actually met on a weekly basis with his firm to aggressively address any and all services issues. Mr. Canning's team has had the same responsible senior account manager assigned to it for several months, on a full-time basis, because of her years of experience in the industry.
Furthermore, we recently sent additional representatives from our account management group to Physician's Computer Company offices in Vermont and hosted its chief operating officer and director of electronic data interchange services for a meeting in our Nashville, Tenn., offices.
During this meeting, Mr. Canning's team told us that it was impressed with the responsiveness and professionalism of our customer service operations and that it wished Mr. Canning's own company, PCC, had the same sophisticated customer service tools as WebMD.
To date, HIPAA implementation has brought about less standardization in format and content, not more. It is important for your readers to note that the clearinghouse function WebMD provides helps standardize the system and substantially reduces the time it takes for providers to send claims to multiple payers, retrieve reports and get paid, freeing up medical and administrative staff to deal with patients.
We apply hundreds of unique and changing payer claim acceptability rules that individual medical practices can't possibly track efficiently. WebMD remains committed to its customers and to solving today's health care problems.
Tony Holcombe
President, WebMD Envoy
Elmwood, N.J.