Ok, Cigna, you really need to get your act together. The other day, I had a patient (one of our regulars) come in with an Augmentin Rx for her son. Her employer had just switched their carrier to Cigna, but she hadn’t received the new card yet.
So, I think, no big deal. Call Cigna, give them name, DOB, address if neccesary. Wrong!
Once I finally got through to somebody, I was asked for my name, pharmacy name, NPI#, Rx#, and the patient’s name. (after I had given all of this to Cigna’s lovely IVR system.)
I explained the situation to the representative. She told me that I needed the primary cardholder’s social security number due to the “new HIPAA law.” (What, you mean the one that was passed in 1996 and its “final rule on Security standards” went into effect in 2003?)
I calmly explained to her that HIPAA doesn’t apply to me because I am a health provider using the information for provision of health services. As long as I can verify basic information (such as name, DOB, address, and phone number), I am entitled to the account number. Her response: “Sorry, I’m just following the law.” My response: “Well, then every other insurance company is violating it.” Click.
I called back, to get a second opinion, as it were. This time I was told the same thing, except that it was due to Cigna policy, not HIPAA. So, I called the mom back and asked her for the account holder’s SSN. She was understandably reticent to give it to me, until, of course, I told her how much it would be without insurance. I had her write it on the back of the Rx, but she made me promise that the pharmacist would cover it, so other nobody else could see it when we were done.
So, I called back (again), this time with the SSN in hand, and got the ID#. I asked this representative, “By the way, is it Cigna policy that I have to have the social security number to get an ID number?” She told me no, so I asked, “Well, then why did not one, but two other reps tell me that it was?”
“I apologize for that. It’s easier to look it up by SSN than by using name and dob, and some of the other representatives are just lazy.” They must have felt my jaw dropping to the ground in China when I her that. I told her that I wanted a complaint filed that Cigna needs to get their reps off their butts and stop lying to pharmacies.
This is particularly annoying when Medco (don’t get me started on Medco) will give you the ID without even having to speak to a live person (which is no fun with Medco).
