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Archived HIPAA News
One of our goals at AdminaStar Federal is to provide you with the
most up-to-date information available. On this page, you will find
Archived HIPAA news. Please scroll to your topic of choice:
| Archived HIPAA information for All Providers |
- X12N Health Care Eligibility Benefit Inquiry and Response (270/271) Posted 01/13/05
The Centers for Medicare & Medicaid Services (CMS) is making changes to its Information Technology (IT) infrastructure to address standards for Medicare beneficiary eligibility inquiries and data access needs identified to implement the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA).
- Free Provider-Specific HIPAA Roundtable Audio-Conferences
Posted 07/03
The Centers for Medicare and Medicaid Services (CMS) Region V
Chicago, in association with the Midwest Center for HIPAA Education,
is pleased to invite you to participate in a FREE HIPAA Implementation
Roundtable Audio-Conference specifically geared toward your provider
specialty.
All of the Roundtables have a common agenda, with the issues,
discussion and questions focused on your provider specialty.
The agenda, schedule of roundtables and other information necessary
for participation can be found at: http://www.mche.us.com/teleconferences.shtml
Schedule of Planned Audio-Conferences
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| July 9, 2003 1:00-2:30 CST |
Mental Health Specialty |
| Roundtable Telephone Number: 877-381-6315 |
ID Number: 592909 |
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July 16, 2003 1:00-2:30 CST
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Durable Medical Equipment |
| Roundtable Telephone Number: 877-381-6315 |
ID Number: 900341 |
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July 23, 2003 1:00-2:30
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Home and Community-Based Waiver Programs and
Local Public Health |
| Roundtable Telephone Number: 877-381-6315 |
ID Number: 592943 |
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July 30, 2003 1:00-2:30
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Ambulance (TCS) |
| Roundtable Telephone Number: 877-381-6315 |
ID Number: 593016 |
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Your Input Requested: If you have HIPAA questions that you
would like addressed during one of the Roundtables, please submit
them in advance to support@mche.us.com. A transcript of each
Roundtable will be available on this web page approximately
14 days after each of the Roundtables.
NO REGISTRATION REQUIRED. However, the number of available
telephone lines is limited.
| To Participate: |
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Choose your Provider Type |
| 2. |
Call the Roundtable Telephone Number 10-15 minutes before
the Scheduled Time |
| 3. |
Tell the Operator the Roundtable ID Number |
| 4. |
The Roundtable will begin at the Scheduled Time |
- The Hype about HIPAA
- If you haven't heard of HIPAA, you have a lot of catching
up to do!
In 1996 Congress passed into law the Health Insurance Portability
and Accountability Act (HIPAA). This Act is comprised of
two major legislative actions: Health Insurance Reform and
Administrative Simplification. The Administrative Simplification
provisions of HIPAA direct the federal government to adopt
national electronic standards for automated transfer of
certain health care data between health care payers, plans,
and providers. This will enable the entire health care industry
to communicate electronic data using a single set of standards
thus eliminating all nonstandard formats currently in use.
Once these standards are in place, a health care provider
will be able to submit a standard transaction for eligibility,
authorization, referrals, claims, or attachments containing
the same standard data content to any health plan. This
will "simplify" many clinical, billing, and other
financial applications and reduce costs.
The Transaction Final Rule is the first of the Administrative
Simplification requirements to be published in the Federal
Register. It was published on August 17, 2000 and requires
providers to use the applicable standards for electronic
transactions such as: submitting claims; receiving remittance
advice statements; querying patient eligibility; checking
claim status; requesting prior authorization where required
for certain items of durable medical equipment; or requesting
payment for the limited number of drugs covered by Medicare.
These standards will be fully implemented October 16, 2002
(October 16, 2003 for small health plans). When fully implemented,
Medicare contractors and other health care payers will be
prohibited from accepting or issuing transactions that do
not meet the new standards.
Health care providers and suppliers who conduct business
electronically are urged to begin considering what steps
they may need to take to upgrade their software to conform
to the new standards. This can be done either independently
or through commercial vendors. Health providers can also
consider arranging for the services of a commercial clearinghouse
or billing service knowledgeable about the new requirements
to translate data on their behalf.
A copy of the Transaction and Code Set Final Rule, as well
as more information on the full range of Administrative
Simplification requirements (including identifiers, security
and privacy of health information proposed rules) can be
obtained from the following web site: http://aspe.hhs.gov/admnsimp/.
Look for further important HIPAA information in upcoming
issues of this publication.
| Achived HIPAA Information for Carrier |
| Achived HIPAA Information for Jurisdiction B DME MAC |
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Invalid Diagnosis Code Editing Posted 11/03/04
This Medlearn Matters article explains about the new edits that will be added to the Medicare claims processing
systems to prevent acceptance of inbound claims with invalid diagnosis codes.
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X12N 837 Professional Implementation Guide (IG) Edits Posted 02/04
Additional information regarding the rejection of electronic claims that are non compliant per the HIPAA X12N 837 Professional Implementation Guide.
(Transmittal 86, Change Request 3050, dated 02/06/04)
- HIPAA 837 Transmission Type Code
(Transmittal B-02-068, dated 10/25/02)
This article advises of acceptable values in the Transmission
Type Identification Segment, REF02 element of the 837 X12N 4010
Professional Health Care Claim.
- Remittance
Advice Coding Update Posted October 2002
(Transmittal AB-02-142, dated 10/18/02)
This document advises of the updated reason and remark codes approved
by the Centers for Medicare and Medicaid Services (CMS).
| Archived HIPAA Information for Intermediary |
- Remittance
Advice Coding Update Posted 10/02
(Transmittal AB-02-142, dated 10/18/02)
This document advises of the updated reason and remark codes approved
by the Centers for Medicare and Medicaid Services (CMS).
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