Health Insurance for International Travelers

If you are planning a trip overseas then you have probably wondered how your US medical plan will cover you outside of the U.S.

If you have a managed care (HMO) plan, then you might not have any coverage outside of the US. Any coverage you do have with an HMO is likely to be significantly reduced when you travel, with greater out-of-pocket expense for treatment outside of your normal coverage area.

Privately issued medical insurance usually does cover you during overseas travel, but the cost of obtaining records, translating them into the English language, converting the currency, and delivering payment overseas is all your responsibility, not the insurers.

One easy option is to have a short term medical policy specifically designed to cover international travelers to supplement your primary coverage. Fortunately these are inexpensive and easy to obtain. Since these plans specialize in international travel, there are fewer hassles typically associated with health plans. The coverage can usually be issued in about two days with a confirmation sent by fax or e-mail to your travel destination if necessary.

See the FAQs at www.medsave.com for more details.

If you have a managed care (HMO) plan, then you might not have any coverage outside of the US. Any coverage you do have with an HMO is likely to be significantly reduced when you travel, with greater out-of-pocket expense for treatment outside of your normal coverage area.

Privately issued medical insurance usually does cover you during overseas travel, but the cost of obtaining records, translating them into the English language, converting the currency, and delivering payment overseas is all your responsibility, not the insurers.

One easy option is to have a short term medical policy specifically designed to cover international travelers to supplement your primary coverage. Fortunately these are inexpensive and easy to obtain. Since these plans specialize in international travel, there are fewer hassles typically associated with health plans. The coverage can usually be issued in about two days with a confirmation sent by fax or e-mail to your travel destination if necessary.

See the FAQs at www.medsave.com for more details.

Tony Novak, MBA, MT is a writer and financial adviser in Narberth, PA focusing on tax and employee benefit issues. His businesses www.MedSave.com and Freedom Benefits Association provide online benefits enrollment for thousands of individuals and businesses nationwide.

Understanding Health Insurance Coverage: A Primer

Health Insurance Coverage: What are Covered Services?
Health insurance coverage is a contract used to determine medical benefits that are covered, or not covered, between you and your insurance provider. The insurance company, based on a fee that you provide them on a regular basis, promises to pay health insurance coverage on certain items or benefits listed in that contract. These are called covered services. Covered services can include a wide variety of things, such as implements, prescriptions, services (such as massage), checkups, tests and/or research.

Your contract should also list all of the things NOT covered in your health insurance coverage these are items or services that you will need to pay for out of your own pocket, should you require them.

Health Insurance Coverage: What is a Medical Necessity? How is this Different from Covered Services?
Just as it seems, a medical necessity is something that your health professional has deemed a required service/ item that will affect your health negatively should you decide not to purchase it. However, just because your doctor tells you something is a medical necessity does not mean your health insurance actually offers coverage for it.

Since insurance companies decide what health coverage they will and will not provide, you really have no leeway in this area.

Health Insurance Coverage: What Do I Do?
Most doctors try and keep themselves abreast as to what the major insurance companies do, and do not cover when it comes to health coverage. However, there are a LOT of plans out there, so this just isnt enough. So how can you avoid any nasty surprises during an emergency?

Read your health insurance coverage. Youre better off knowing what your health insurance company will, and will not provide coverage for right off the bat. Then, if your doctor decides on a treatment plan that isnt covered, you can ask for alternatives that may be.
If there are questions regarding your health insurance coverage, do not hesitate to contact the insurance company. Questions are good, and they expect them.

Health Insurance Coverage: What Do I Do if Something I Need Isnt Covered?
The gross majority of what your doctor orders for you will be covered in your health insurance plan. If you do get a treatment or supply that isnt covered, you can always challenge the health insurance coverage. You may not be the only one who requires the same type of service, benefit or item so youll end up fighting not just for yourself, but for others in the same situation.

Ask your doctor for their side, and use this in your claim. It may not help in the end, but if your doctor is on your side, you may be able to convince the health insurance company that coverage is required.

For more more information about health insurance coverage please visit http://www.1health-center.com/articles/Health-Insurance-Coverage.php

7 Steps To NPI For HIPAA-Compliant Electronic Medical Billing Software And Service

The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers for health care providers, as well as the adoption of standard unique identifiers for health plans. They become mandatory on May 23, 2007.

The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information. The Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign these unique identifiers.

CMS has contracted with Fox Systems, Inc. to serve as the NPI Enumerator. The NPI Enumerator is responsible for dealing with health plans and providers on issues relating to unique identification.

HCFA Timetable

Changes in the HCFA 1500 form to accommodate the NPI number took place January 1, 2007. Until March 30, 2007, using NPI number on the HCFA form is optional but as of April 2, 2007, using NPI becomes mandatory.

Getting an NPI is free - Not Having One Can Be Costly: If you delay applying for your NPI, you risk your cash flow.

 

1. Enumerate: Enumeration is mandatory for both individual providers and organizations and subparts. When applying for your NPI, CMS urges you to include your legacy identifiers, not only for Medicare but for all payors. If reporting a Medicaid number, include the associated State name. This information is critical for payors in the development of crosswalks to aid in the transition to the NPI.
2. Update: Make sure to upgrade your software, HIPAA Transactions, CMS1500, UB04, and/or Dental claim form changes.
3. Communicate: Notify your payers once you have obtained your NPI number. As outlined in the Federal Regulation (The Health Insurance Portability and Accountability Act of 1996 (HIPAA)) you must also share your NPI with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes -- including designation of ordering or referring physician.
4. Collaborate: Check the readiness of your payment partners (such as health plans, TPAs, clearinghouses, etc...)? Not all payers are ready to accept the NPI number at this time. Use both your existing (legacy) number and the NPI number when submitting electronic claims.
5. Test: Test transactions well before the deadline. Make sure to test HIPAA Transactions, e.g., 837 Claims, 835 Remittance Advice, and, if you submit paper claims, verify that the data is printed in the correct fields. The new HCFA form has new fields for identifier numbers on lines 17b, 32a and 33a.
6. Educate: Focus on staff working on insurance verification of eligibility and claim denial or underpayment follow up.
7. Implement: Once you obtain your NPI, it might take about 120 days to do the remaining wo

   rk to use it. This includes working on your internal billing systems, coordinating with billing services, vendors, and clearinghouses, testing with payers.

   Yuval Lirov, PhD, author of Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP Notes, Care Plans, Coding, Billing, Collections, and Audit Risk (Affinity Billing) and Mission Critical Systems Management (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net - Distributed Billing and Practice Management Technologies. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com

Alert: New HIPAA Rules Could Affect Your Organization's Email System

On April 21, 2005, a new Health Insurance Portability and Accountability Act (HIPAA) security rule went into effect. The requirements of this rule, which are basically information security best practices, focus on the three cornerstones of a solid information security infrastructure: confidentiality, integrity and availability of information.

The HIPAA regulatory requirements encompass transmission, storage and discoverability of Protected Health Information (PHI). Given the widespread use and mission-critical nature of email, enforcement of HIPAA encryption policies and the growing demand for secure email solutions, email security has never been more important to the healthcare industry than it is right now.

Although many assume it applies only to health care providers, HIPAA affects nearly all companies that regularly transmit or store employee health insurance information. HIPAA was signed into law in 1996 by former President Bill Clinton, with the intent of protecting employee health and insurance information when workers changed or lost their jobs. As Internet use became more widespread in the mid-to-late 1990s, HIPAA requirements overlapped with the digital revolution and offered direction to organizations needing to exchange healthcare information.

HIPAA in the Workplace
Collaboration between employers and healthcare professionals has grown increasingly digital, and email has played an ever-increasing role in this communication. However, email’s increased importance can lead to severe consequences without proper security and privacy measures implemented.

In addition to the usual concerns about privacy and security of email correspondence, even organizations that are not in the healthcare industry must now consider the regulatory compliance requirements associated with HIPAA. The Administrative Simplification section of HIPAA, which, among other things, mandates privacy and security of Protected Health Information (PHI), has sparked concern about how email containing PHI should be treated in the corporate setting. HIPAA, as it relates to email security, is an enforcement of otherwise well-known best practices that include:

* Ensuring that email messages containing PHI are kept secure when transmitted over an unprotected link

* Ensuring that email systems and users are properly authenticated so that PHI does not get into the wrong hands

* Protecting email servers and message stores where PHI may exist

Organizations regulated by HIPAA must comply and put these practices in place. However, the need to comply with regulations puts particular pressure on the healthcare industry to enhance their use of technology and “catch up” with other industries of similar size and scope.

Privacy and Email Security
The privacy protection provisions in HIPAA pose a major compliance challenge for the healthcare industry. These provisions are intended to protect patients from disclosure of any of their individually identifiable health information. Organizations that fail to protect this information face fines ranging from $10,000 to $25,000 for each instance of unauthorized disclosure. If the disclosure is found to be intentional, HIPAA provides for fines ranging from $100,000 to $250,000 and possible jail time for individuals involved in the violations.

The clock is ticking – it’s time to get started
Bringing an enterprise into compliance with the rules set by HIPAA can seem like a very daunting task to even the most experienced executives. Nonetheless, the growing dependence on email as a mission-critical application requires that your organization implement comprehensive security and privacy policies – and soon. A solid combination of security policies and the technologies to enforce those policies can ensure improved security as well as HIPAA readiness and ongoing adherence.

Dr. Paul Judge is a noted scholar and entrepreneur. He is Chief Technology Officer at CipherTrust, the industry's largest provider of enterprise email security solutions. Learn how to make your email system comply with HIPAA regulations by visiting http://www.ciphertrust.com.