If you answered "yes" to either of these questions, do you know if the company submitting your claims has been certified by nationally recognized firms specializing in evaluating HIPAA transactions compliance, such as Claredi or Edifecs? Has your biller successfully tested its system with your key payers? Has it begun mapping your data to the new HIPAA-compliant formats?

If you answered "no" to any of these questions, it is very likely that your cash flow after October 16 will be negatively impacted.

At a recent HIPAA summit in California, key commercial and governmental payers confirmed that only a few providers had successfully tested their ability to transmit HIPAA-compliant claims. While several payers plan to support alternative methods of processing, such as direct data entry during the transition period, none of them had developed contingency plans to deal with the anticipated influx of paper claims.

CMA has prepared a brief checklist of what you can do now to minimize your risk of post-October 16 cash flow disruptions. Click here to download the checklist.

Contact: CMA’s HIPAA help line, 415/882-3311 or legalinfo@cmanet.org.