Consider a clearinghouse for transactions and code sets
HIPAA Weekly Advisor, August 2, 2002
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Unlike health plans, providers have options for complying with HIPAA's transactions and code set requirements. In some cases, they can continue to submit paper transactions.
Some may use direct data entry to payers via the Web if their payers continue to support this. And others might send non-standard transactions through a clearinghouse.
"You may want to consider using a clearinghouse for at least a while until you get all the formatting requirements in place, and we have all the national health plan and provider identifiers to make sure we have the correct electronic addresses for each provider and payer," said Margret Amatayakul, RHIA, FHIMSS, owner of Margret A Consulting, LLC, an independent consulting firm based in Schaumburg, IL.
In addition to needing more information, you may need more technology than you currently have to handle all transactions without the assistance of a clearinghouse. "You may not have enough band width to distribute transactions to all the various payers," she explained.
Amatayakul and Steven S. Lazarus, PhD, FHIMSS, president of Boundary Information Group in Denver and chair of the Workgroup for Electronic Data Interchange, discussed developing an implementation plan at The Greeley Company's May 29 audioconference, Implementing HIPAA's Transactions and Code Sets. The Greeley Company is a division of HCPro in Marblehead, MA, which publishes BOH.
Go to http://www.himinfo.com/news/feature.cfm?content_id=23251 to read more.
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