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HIPAA EDI Practice Management Systems Directory

HIPAA Resources

HIPAA Article

 

HIPAA EDI Practice Management Systems Directory
(Web site: www.hipaa.org/pmsdirectory) Medical practices and other providers are required by HIPAA to utilize new standard electronic formats for exchanging administrative information (claims forms for example) with health plans and insurance companies after October 15, 2003. This is also the date after which Medicare will only accept claims submitted electronically; these, too, must be in HIPAA standard formats. Most physicians will depend on their practice management system (PMS) software vendors, or billing and accounting software vendors, to assist the practice transition from electronic submission of data in non-HIPAA formats to submission in HIPAA-standard formats. There is no such thing as "HIPAA compliant" software. The responsibility to be compliant rests with the practice. However, the software can be "HIPAA ready" or not. This Directory, found on the Internet at www.hipaa.org/pmsdirectory was conceived and designed to make it easy for a medical practice to determine when and how a practice management system software product will be ready to submit and receive HIPAA standard transactions, as well as to provide information about whom to contact at the company for further details on their HIPAA implementation strategy. The individual vendors have supplied their own information about their companies and products. The accuracy of this information is not guaranteed and should not be used for business purposes without independent verification. The AOA and the other organizations bringing you this directory do not endorse the vendors listed or endorse, guarantee or warrant their products, and they reserve the right to delete postings that do not satisfy the purpose of providing information on vendors' HIPAA-readiness. This directory is for informational purposes only. Please contact Janet Horan at jhoran@aoa-net.org or 800-621-1773 ext. 8187 for further information.
 

HIPAA Resources


1. CMS Website - http://www.cms.hhs.gov/hipaa - Our model compliance extension form, Frequently Asked Questions, links to other HIPAA sites, and information on regulations and the law are located here.

2. FREE Video - CMS' Meeting the HIPAA Challenge: Implementing the Administrative Simplifications of HIPAA. For free video, e-mail your request to AskHipaa@cms.hhs.gov or call 410-786-4232.

3. FREE HIPAA Roundtable Conference Call - September 30th, 2002, 2:00-3:30 PM EST. Call in number 1-800-837-1935, conference ID #5260079. To request an official invitation to the call, e-mail AskHipaa@cms.hhs.gov or call 410-786-4232. This is a good place to get answers to your questions on HIPAA Administrative Simplification.

4. FREE Listserve - http://aspe.hhs.gov/admnsimp/lsnotify.htm - Sign up to receive notification when proposed or final rules on HIPAA have been published in the Federal Register (The Federal Register is the place where the government, upon passing a law, tells the public how the law will be implemented).

5. CMS E-Mail box - askhipaa@cms.hhs.gov. Send your questions on HIPAA administrative simplification here.

6. CMS HIPAA Hotline - 410-786-4232 - This hotline has been established to help answer your HIPAA administrative simplification questions.

7. Privacy-related information -
http://www.hhs.gov/ocr/hipaa/whatsnew.html - The U.S. Department oF Health & Human Services' Office for Civil Rights oversees the privacy requirements. Visit their website for more information. Privacy-related questions should be directed to OCRPrivacy@hhs.gov or call 1-866-627-7748.

8. Other information on "administrative simplification" requirements of HIPAA- http://aspe.os.dhhs.gov/admnsimp/

9. CMS Medicaid HIPAA web address -
http://www.hcfa.gov/medicaid/hipaa/adminsim/

Mari Rose Johnson
HIPAA Project Staff
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Mailstop: C5-24-04
Baltimore, MD 21244
(410) 786-6678 (p)
(410) 786-1347 (f)


HIPAA Article

Centers For Medicare & Medicaid Services Health Insurance Portability & Accountability Act

The Health Insurance Portability & Accountability Act (HIPAA) is a federal mandate passed by Congress in 1996 that addresses the high administrative costs of health care. HIPAA provides standard formats for transmitting health care transactions, which will simplify, improve efficiency, and encourage health care transactions to be conducted electronically. HIPAA applies to all "covered entities", which are defined as providers who transmit health care transactions electronically, health plans, and clearinghouses. The Centers for Medicare & Medicaid Services (CMS) has been delegated authority over HIPAA Administrative Simplification provisions, which include the Transaction & Code Set Standards. Medicare will not accept paper claims after October 16, 2003, with few exceptions.

HIPAA requires compliance with the Transaction & Code Set Standards by October 16, 2002. The Administrative Simplification Compliance Act (ASCA) allows for a one-year extension with submission of a compliance plan by October 15, 2002, either by paper or preferably electronically at www.cms.hhs.gov/hipaa/hipaa2/ascaform.asp.By filing for the one-year extension, covered entities need to begin testing for HIPAA compliance by April 2003 and become compliant by October 16, 2003.

There are resources available for implementation assistance. MedLearn (www.cms.hhs.gov/medlearn) offers schedules for upcoming HIPAA satellite broadcasts and conference call roundtables. Roundtables are a forum for discussion and questions between providers and CMS. Free implementation guides may be downloaded from the Washington Publishing Company at www.wpc-edi.com/hipaa. The Workgroup for Electronic Data Interchange (www.wedi.org) provides implementation assistance through their Strategic National Implementation Process (http://snip.wedi.org). For more information, call the CMS Regional Office HIPAA Hotline at 312-353-1400. Questions may also be submitted by email at askhipaa@cms.hhs.gov

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