Insurance carriers who won't disclosure to 3rd parties

[HIPAALove]

Hello - Not sure if this is the place for this, but I figured I'd give it a shot. I work for a company that performs back office processes for orthodontists, e.g. billing and insurance. There is an increasing trend for carriers to essentially blacklist us so that we cannot get the necessary eligibility and claims information to assist the practices. We have BAAs with each practice and letters from the practices giving us carte blanche access to this info. However, despite HIPAA clearly stating that business associates are privy to this info, many carriers are shutting us out.

Any bright ideas from carriers or from anyone in the medical field that has encountered this would be greatly appreciated.

Thanks!

 

[adjusterjack]

we cannot get the necessary eligibility and claims information to assist the practices.

Why do you need eligibility and claims information to "assist the practices"?

 

[HIPAALove]

A new patient at one of our partner practices will need to know the specifics around their orthodontic insurance. Instead of the ortho calling to find out, we take that off their plate. Sometimes we can get the necessary info via the carrier's website, many times we cannot.