Health Information Management

Group urges HHS to provide more transactions guidance

HIPAA Weekly Advisor, October 3, 2003

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HIPAA's transactions and code sets rule requires providers to obtain a variety of new data elements that have historically not been necessary for payors to process health care claims, according to a September 23 statement submitted to the Senate Special Committee on Aging by American Clinical Laboratory Association (ACLA) President Alan Mertz.

Mertz urged the Department of Health and Human Services (HHS) to provide more specific guidance to assist providers struggling with implementation of the transactions standards. "HHS must streamline the mechanisms for development and maintenance of the transaction standards," he added. "There are increasing concerns throughout the health care industry about the possible adverse impact on the health care system from implementation of the standards."

The unique role of laboratories as indirect treatment providers also creates additional complexity in complying with some of the details of the standards, said Mertz. "HHS should make clear that less-than-perfect claims (including those that contain errors and those that are missing certain data elements that are not necessary to adjudicate the claim) are 'compliant claims."



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