Socialized medicine - would we still have to deal with billing?

As a nurse manager, I often help my patients deal with medical billing. I know that it can be frustrating and confusing. I still get confused and I have a lot more information at my disposal. I think it is truly sad that we have a cottage industry in people who make money trying to help other people deal with billing and insurance questions. I don't imagine more rules through Congress will help. My guess is that the only way to get this thing fixed is to have a 10-year-old cut through the crap and write our health care policy from scratch.

Today, I called billing again to help two patients deal with some issues. This time, the billing person told me that I would need a release of information form signed by the patient before she could give me any information on the account. What?!?!?

I repeatedly told this person that I was a) part of the care team for these patients, b) handling a billing issue (both of which allow me information under the HIPPA law without a release), and c) I was ALREADY looking at the account and had in fact given her all the information off the account to look it up while I was on the phone with her. I was reading the physician notes to her so we could address the problem.

She persisted. She kept telling me I had to get a release signed by the patient to give me the information.

Uh...I'm not somebody's aunt Millie, looking for information on someone's diagnosis so I can gossip. I am calling on behalf of the patient and doctor to solve a billing issue! She has my information in the patient's account as addressing the billing questions before.

So, the very person assigned to handle billing doesn't understand the basic HIPPA law covering insurance issues in healthcare. Helpful. No wonder my patients are struggling.

People complain about members of Congress not reading the thousands of pages of the new law. What about the people in health care and insurance who are charged with making the new law work for patients and providers? Not one of them has read it and it seems that our entire medical billing system is working on gossip.

When we define our payments on a version of the "telephone game", how do we expect to maintain high levels of care?