...we believe having a standard identifer is extremely
important for the administrative simplification of the health care
business. It is also an opportunity to apply these standards to
managing information that will ultimately improve the health and well
being of all Americans.
United HealthCare has, over time, combined with several health
plans, and as a result, has long recognized the need to simplify
health care administration by adopting national standards...
United HealthCare currently enrolls members utilizing a number of
data elements such as the member's Social Security Number, name,
gender, date of birth, and address. In addition, we generally link
covered dependents to the member's identification number. When we
receive a request for payment, we match the information on the claim
to the information contianed in a master person
index, and route the claim data to one of several claim system
platforms...
Today members are very familiar with the United HealthCare
identification number, because it is generally based on their Social
Security Number, or an alternative they supply to us. Even when the
health care is not available in an emergency situation, the provider
is able to contact us by phone to verify the coverage. An identifier
other than the Social Security Number will not have a positive impact
on the process.
It should be noted that the 1993 WEDI [Workgroup for Electronic
Data Interchange] Report, Appendix 4, Unique Identifiers for the
Health Care Industry, Addendum 4 indicated 71%
of the payers responding to the survey based the individual
identifier on the Member's Social Security Number. However 89%
requested the insured's Social Social Security Number for application
of insurance. Clearly the Social Security Number is the
current de facto identifier...
Electronic Data Interchange with providers continues to grow at a
steady pace. We would expect a Unique Health Identifier for
Individuals to facilitate an increase in the electronic transaction
volume. This is due to the confidence trading partners would have in
utilizing a standard identifier, and the result of reducing the
number of rejected transactions.
In the current environment, the requirements for member
identification for electronic claims and paper-based claims are the
same. There is some difference in the efficiency of locating member
records when the claims are submitted on paper. This is due to the
lack of completeness and accuracy of the paper forms and the need to
transfer the information into an electronic format. For paper-based
submissions, the result is an increase in the number of records that
must be manually reviewed...
We suggest that any numbering system will inherently generate
problems associated with duplicate numbers, enumerating individuals
not incorporated into the system, adn transition to the standard. We
have also concluded from a cost perspective, the Social Security
Number would be the lowest cost option. We believe an investment in
enhancement to the enumeration process via the Social Security
Administration would provide the health industry with an opportunity
to move the administrative simplification process forward, rather
than starting over with a new administrative system for assigning
unique identifiers...
