I'm self-insured and pay my own insurance. I also work in the mental healthcare field, doing billing for counselors. For years, I've watched the difficulty people have in actually obtaining coverage from insurance plans.  It's as if they pay these high premiums and then insurance companies look for ways to avoid coverage for the client.

I believe it's time insurance companies quit making millions by creating such a nightmare maze for processing of claims and coverage.  It's time our country focused on easily accessible, preventive healthcare instead of the current environment where the insurance industry calls the shots, with little recourse for either insured or providers.

My recommendation to the Obama-Biden team: Streamline the insurance billing process !

Technology is in place to develop such protocols.  The sophistication of credit card technology & companies already use it millions of times daily (identiying card holder and biller, items purchased, cost, allowable amounts that can be charged on the card, etc). 

If a project was established (possibly developed through grants or funding by the government), whereby any provider with a processing terminal could immediately be compensated for care or services provided, the healthcare industry could be overhauled more effectively. 

This could be done by
1/swiping the insured's card at time services were provided on a credit card type terminal
2/having terminal identify provider's NPI # automatically
3/have provider's office indicate cost, DX and type of service
4/have patient confirm the service with an insurance assigned password (such as they now sign their name)
5/insurance company would automatically pay (right then and there) into the provider's assigned account what they would normally process days later via paper or electronic billing. 
6/Small paper receipt is printed (such as one receives on credit card processing).
7/For out-of-network providers, the same process could be implemented, with a slight change in steps....indicating how much the insurance was going to cover for that particular session (test or proceedure), and immediately indicate the balance owed by the insured.
8/Client would pay balance due with their credit card, hsa acct, etc.

This would allow providers to obtain payment immediately from both the insurance company and client, saving millions of dollars now being wasting (& is not environmentally friendly) by repeated paper billings, electronic billings EOB's, client statements, envelopes, postage, wasted staff time, and high overhead costs (which are then passed on to the patient or client).

The technology is already in place for such a program to be developed.  It would
1/Save millions of dollars to providers and hospitals
2/Prevent increased provider overhead operational costs
3/Prevent insurance companies from getting out of paying for services that the insured should have covered.
4/allow insured patients to know exactly what  coverage they have immediately, not weeks later.
5/Prevent insurance companies from overwhelming the insured client, or overloading providers, with paperwork, requests for more information which is unnecessary or has already been provided.

Insurance companies have already reached the point where their allowables, fees, policies are online, yet they appear unwilling to make the process easier for the clients and providers.  They want providers to wait weeks, sometimes months or even years to receive payment for services they have provided.

People speak of insurance fraud and act as if providers are trying to abuse the system.  From where I sit, I instead see the unethical behaviors as being the insurance industry trying not to cover the insured or providers.  Providers lose so much yearly just fighting insurance companies for services they provided.  They have to hire staff to do this so they can continue to provide care and their overhead costs are unbelieveable...simply due to insurance companies tactics.

It's time they were held accountable and required to pay immediately for services for which the client has already paid their premiums to receive.

We encourage you to organize a team to brainstorm, research & develop such a project (incorporating necessary safeguards and anti-fraud protections), develop bids or award contracts.

The time has come to simplify the entire healthcare industry.  Coverage is the #1 issue, but the #2 issue is allowing clients to know their coverage quickly and  insuring payment for services rendered for the provider are received.