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Untitled Document
The HIPAA Electronic Transactions
Deadline Is Here. Now What?
[Posted 10/16/03]
The HIPAA Transactions and Code Sets Rule deadline has finally arrived. Is your practice ready to begin submitting HIPAA-compliant standard transactions? If not, you’re not alone.
Recognizing a low level of HIPAA-readiness among providers, some health plans have implemented contingency plans and will accept both the new formats and the old electronic formats for a limited time. But even if the health plans you work with have a contingency plan in place, this “grace period” may end without notice. It is still very important that your practice make the transition to HIPAA-compliant billing systems as soon as possible.
How can you get caught up on HIPAA? Take a look at the numerous resources listed below that are available to CMA members.
If you still have questions after reviewing these resources, contact CMA’s HIPAA help line at 415/882-3311
or legalinfo@cmanet.org.
HIPAA Transaction Rule Primer for Physicians:
CMA ON-CALL document #1606, “HIPAA Electronic Transaction Rule,” discusses HIPAA’s electronic transactions and code-sets (TCS) rule, which standardizes claims submission, processing, and payment, and provides a step-by-step guide so that physician offices can prepare to send HIPAA-compliant claims. ON-CALL documents are free to members at CMA’s members-only website. Nonmembers can purchase ON-CALL documents for $2 per page from CMA’s online bookstore at http://www.cmanet.org.
CMA’s HIPAA Help Center:
All of the HIPAA stories that have appeared in CMA Alert over the past year are available in one convenient index at the California Physician website. These articles provide answers to some of the most common HIPAA questions and clarification of some of the most common HIPAA misconceptions. There you will also find links to all of CMA’s HIPAA products and resources for physicians.
Electronic Transactions Compliance Toolkit CD-ROM:
CMA has partnered with PrivaPlan to bring members an affordable CD toolkit designed to help physicians make smart decisions about compliance with HIPAA’s TCS rule. The CD includes guidance on replacing or upgrading billing software; information on how to minimize claims delays or denials; and a tool to help physicians map their claims data from the existing HCFA 1500 claim form to the new HIPAA-standard form.
CMA members who previously purchased the CMA/PrivaPlan
HIPAA Privacy and Security Toolkit can order this TCS toolkit for $50. The fee for CMA members who do not own the privacy and security toolkit is $75. The nonmember price is $100.
To download an order form, click here.
HIPAA-Compliant Clearinghouse Discount for Members
CMA has partnered with Infinedi, a Tulsa, Okla., electronic clearinghouse, to ensure your practice’s cash flow is not interrupted by new HIPAA mandates. Physicians can choose a flat rate monthly service, which permits unlimited electronic claims filing, or opt for a per-transaction payment plan. CMA members receive a discount of 8 to 12 percent. You don’t need special software. Claims can be transmitted 24 hours a day to Infinedi’s web portal via secure FTP, or by modem through a toll-free number. No special software is needed.
Enrollment is risk-free. If Infinedi is unable to convert your existing claims into the new HIPAA formats, the one-time $175 enrollment fee is refunded. (The enrollment fee for nonmembers is $200.) Physicians enrolling will be issued a MEDePass digital certificate for secure access to their private business account information stored at Infinedi.
Click here for more information on Infinedi.
Note to Medical Manager Customers:
Yes, you can use Infinedi. CMA received a number of calls from Medical Manager users who were told that they could not use Infinedi as their clearinghouse, but instead must use the Medical Manager owned clearinghouse solution. CMA contacted Medical Manager about this very serious restriction. Medical Manager has assured us that its customers can use any claims clearinghouse. The company simply won’t guarantee the work of any third-party clearinghouses.
Contact: CMA’s HIPAA help line at 415/882-3311
or legalinfo@cmanet.org.
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