HITing back

An article in Medical Economics about self-service patient check-in kiosks reveals something about modern American health care:

Similar to check-in kiosks found in airports, Clearwave kiosks ask patients to swipe their insurance card or type in the information from it.

The kiosk then recognizes the patient and populates the system with his or her personal and medical information. The kiosk also sends a Health Insurance Portability and Accountability Act 270 inquiry, regarding benefits eligibility and coverage, to the patient’s insurance company.

The insurance company, in turn, sends a HIPAA 271, which tells the practice everything it needs to know about the patient, including co-pay, co-insurance, deductible, and how much of the deductible has been met.

For a quarterly fee, Clearwave provides real-time updates of insurance company information.

Verifying eligibility status, for example, can be a time-consuming chore for an office administrator. The kiosks, on the other hand, connect directly to more than 1,000 insurance companies and provide an automated response in 10 seconds, according to Clearwave.

“We get the right information, so we can bill correctly, and we get our money from the insurers in a timely manner,” says Galantino, whose wife, Karen LoCicero, MD, is the group’s lead physician.

To me it sounds like having to use a lot of technology just to get someone from the waiting room to the hallway leading to the exam rooms.  And the necessity (real or imagined) for this sort of thing stems from relying on third party payors instead of the patient simply paying directly for the physician’s services.  Speaking of payors, exactly how much does this set up cost?

The kiosks and ongoing fee for the real-time updating of insurance information may represent only a modest investment for many practices. Clearwave has four charges based on the number of patients per day and the number of kiosks needed: $5,000 per kiosk; $3,000 to $5,000 for installation, training, and setup; a $250 to $400 monthly network fee; and $2,000 to $10,000 for integration services.

Dear God, I hope this article is an early April Fools joke!

Unfortunately, these are the kinds of insane “solutions” that get proposed when health care becomes a perpetual street fight with third party payors, government regulation, and medicolegal defense with a bit of patient care done as time permits.  Instead of trying to offset the inefficiencies of the current health care system with exorbitantly expensive gadgets, we should be trying to eliminate, not accommodate, those inefficiencies.

Quite a bit of HIT sounds suspiciously like the Broken Window Fallacy.


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