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HIPAA

HIPAA resources

Adobe PDF icon Passport Health Plan's EDI 835 Companion Guide

Medlearn Matters article: "Medicare Providers: Their Vendors, Clearinghouses, or Other Third Party Billers, and the HIPAA/Medicare Contingency Plan"
http://www.cms.hhs.gov/medlearn/matters/mmarticles/2004/SE0414.pdf

Medicaid HIPAA Administrative Simplification
http://cms.hhs.gov/medicaid/hipaa/adminsim/default.asp

Strategic National Implementation Process
http://snip.wedi.org/

Administrative Simplification
http://aspe.hhs.gov/admnsimp/

Electronic Claims Testing

It is important that all providers who submit electronic claims test with their designated vendors and clearinghouses. An important tool for testing is the companion guide which can be found at these locations at WebMD:

837- Professional: http://www.webmdenvoy.com/HIPAA/professional-detailed-reference.pdf
837- Institutional: http://www.webmdenvoy.com/HIPAA/institutional-detailed-reference.pdf

Electronic Transactions and Code Set Resources

The Centers for Medicare & Medicaid Services (CMS) has resource information on how to become HIPAA compliant. The deadline for electronic transactions and code sets is October 16, 2003. There are a multitude of resources we have found to be very useful. Here are just a few: Questions to ask Vendors, TPAs or Clearinghouses Steps Toward HIPAA Compliance HIPAA Resources Guidance Documents

CMS Webcast

HIPAA Presentations The CMS Southern Consortium's Achieving Compliance Together (ACT) Team has developed a series of HIPAA presentations. They can be accessed via the internet and there is no cost to you. Access these presentations.

You can choose any of the following presentations:

  • Message to Providers
  • HIPAA Basics
  • Provider Steps to Getting Paid
  • HIPAA Security
  • CMS Enforcement of T&CS
  • 837 for Professional Claims
  • 837 for Institutional Claims (Coming Soon)

 
 
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