Tip: Work with other organizations to prepare for transactions and code sets
HIPAA Weekly Advisor, January 20, 2003
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Collaborating on transactions and code sets compliance with other organizations will allow you to share lessons, develop common practices, and find success working with vendors.
"We commiserate on a regular basis with other organizations," says Chris Apgar, CISSP, HIPAA compliance officer at Providence Health Plan in Beaverton, OR.
After purchasing software that translates between its claims system and trading partners, "[Providence] banded together with other organizations that use the same software product and sat down and talked to the vendor," Apgar says. "It has helped that we all voiced the same concerns together. If the vendor knows that a large portion of its customer base has a concern, the answer might come more quickly."
The same group also helped Providence develop companion documents that identify situational fields the organization will require for each transaction, as well as the format for some required fields.
"The taxonomy code, used to identify the specialty of the provider, is an example. Very few health plans use them. We might say not to send a taxonomy code. The documents define those things," says Apgar. "We didn't have to go out and pay for companion documents to be written. A few organizations had drafts we were able to use."
This collaboration has allowed the group to develop industry standards. "You don't want five different payers doing things five different ways," says Apgar. "Our biggest compliance obstacles have been no finality to the rule changes, vendor-reliance, and trying to engage enough people," he adds. "People have become interested in the last six months. Before that, it just wasn't on their radar screen."
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