HIPAA News

Click here for The Hype About HIPAA.

In 1966 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 non-standard 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. 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.

HIPAA Web Addresses

For those using X12N 837 formats, the following is provided to assist in your implementation efforts. The Medicare A 837 health care claim version 305 implementations 3A, 01 and 1A.C1 (Appendix C of both documents have UB-92 mapping), formats are effective through October 16, 2003. The X12N 837 version 4010 (HIPAA) to UB-92 version 6.0 mapping is located at:

http://www.hcfa.gov/medicare/edi/hipaadoc.htm

The 837 version 4010 can be downloaded from:

http://www.wpc-edi.com

Source: The Centers for Medicare & Medicaid Service (CMS) Medicare Intermediary Manual Transmittal 1854, Change Request 2115, dated April 25, 2002.

HIPAA Related Notices and Publications

Change Request 3031, HIPAA X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction, was issued on February 24, 2004. The Centers for Medicare & Medicaid Services issued a companion Medlearn Matters article about this instruction on March 5, 2004. (MM3031). This instruction becomes effective on July, 1, 2004. To access the article please click link: HIPAA X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction

Replacement of Transmission Methods June 14, 2005

HIPAA Update June 2005 June 14, 2005

HIPAA Teleconference January 28, 2005

HIPAA Update November 2004 November 11, 2004

Fiscal Intermediary 835 Flat File and Companion Document Change September 7, 2004

Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction September 7, 2004

Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Institutional Health Care Claim Implementation Guide (IG) Additional Updates September 7, 2004

Health Insurance Portability and Accountability Act X12N 837 Health Care Claim Implementation Guide ICD-9 and Direct Data Entry Instruction June, 10 2004

CMS HIPAA UPDATE April, 2004

List of Providers who have Successfully Completed Testing to Submit HIPAA Claims - April 2, 2004

HIPAA Requirement for Discharge Hour on Inpatient Claims - March 29, 2004

837I Companion Guide (Date of revision: 12/03/03 - March 17, 2004

Health Insurance Portability and Accountability Act(HIPAA) X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction - March 10, 2004

Modification of CMS' Medicare Contingency Plan for HIPAA Implementation - March 3, 2004

HIPAA Guidance December 17, 2003

List of Providers who have Successfully Completed Testing to Submit HIPAA Claims

Organizations Successfully Tested with CareFirst of Maryland – Medicare Part A May 16, 2003


	Click here for The Hype About HIPAA. In 1966 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 non-standard 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. 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. HIPAA Web Addresses For those using X12N 837 formats, the following is provided to assist in your implementation efforts. The Medicare A 837 health care claim version 305 implementations 3A, 01 and 1A.C1 (Appendix C of both documents have UB-92 mapping), formats are effective through October 16, 2003. The X12N 837 version 4010 (HIPAA) to UB-92 version 6.0 mapping is located at: http://www.hcfa.gov/medicare/edi/hipaadoc.htm The 837 version 4010 can be downloaded from: http://www.wpc-edi.com Source: The Centers for Medicare & Medicaid Service (CMS) Medicare Intermediary Manual Transmittal 1854, Change Request 2115, dated April 25, 2002. HIPAA Related Notices and Publications Change Request 3031, HIPAA X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction, was issued on February 24, 2004. The Centers for Medicare & Medicaid Services issued a companion Medlearn Matters article about this instruction on March 5, 2004. (MM3031). This instruction becomes effective on July, 1, 2004. To access the article please click link: HIPAA X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction Replacement of Transmission Methods June 14, 2005 HIPAA Update June 2005 June 14, 2005 HIPAA Teleconference January 28, 2005 HIPAA Update November 2004 November 11, 2004 Fiscal Intermediary 835 Flat File and Companion Document Change September 7, 2004 Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction September 7, 2004 Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Institutional Health Care Claim Implementation Guide (IG) Additional Updates September 7, 2004 Health Insurance Portability and Accountability Act X12N 837 Health Care Claim Implementation Guide ICD-9 and Direct Data Entry Instruction June, 10 2004 CMS HIPAA UPDATE April, 2004 List of Providers who have Successfully Completed Testing to Submit HIPAA Claims - April 2, 2004 HIPAA Requirement for Discharge Hour on Inpatient Claims - March 29, 2004 837I Companion Guide (Date of revision: 12/03/03 - March 17, 2004 Health Insurance Portability and Accountability Act(HIPAA) X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction - March 10, 2004 Modification of CMS' Medicare Contingency Plan for HIPAA Implementation - March 3, 2004 HIPAA Guidance December 17, 2003 CMS Companion Document for the Accredited Standards Committee (ASC) X12N 276/277 Health Care Claim Status Request & Response October 21, 2003 CMS HIPAA UPDATE September, 2003 CMS HIPAA UPDATE August, 2003 Standard Paper Remittance (SPR) Advice August 6, 2003 837I Companion Guide (Date of revision: 7/22/2003) July 22, 2003 CMS HIPAA Update July 18, 2003 Testing and Other Help Available Before the October 16, 2003 Compliance Date for Health Insurance Portability and Accountability Act (HIPAA) Transaction and Code Set Standards July 16, 2003 Free HIPAA Security Web cast Now Available June 30, 2003 CMS HIPAA Satellite Broadcasts and HIPAA Questions and Answers June 30, 2003 HIPAA Claims Testing Notification June 20, 2003 June HIPAA Update June 20, 2003 Attention All Providers - Free CMS HIPAA Training June 10, 2003 HIPAA Provider Outreach Activities May 2, 2003 CareFirst of Maryland – Medicare Part A 837I Companion Guide (Date of revision: 4/17/2003) April 21, 2003 Free Health Insurance Portability and Accountability Act Billing Software April 1, 2003 Medicare Fee for Service Contractor Guidance on the HIPAA Privacy Rule March 20, 2003 0001 Revenue Line Direction for the Health Insurance Portability and Accountability Act (HIPAA) Institutional 837 Health Care Claim - November 21, 2002 HIPAA HHS Press Release - November 11, 2002 The Upcoming Health Insurance Portability and Accountability Act (HIPAA) Deadline October 1, 2002 To Providers: The following is a Press Release Statement from CMS regarding the HIPAA extension. September 6, 2002 Implementation of the Transmission Control Protocol/Internet Protocol(TCP/IP) for the Health Insurance Portability and Accountability Act (HIPAA) Health Care Eligibility Benefit Inquiry and Response Transaction (270/271) standard. September 6, 2002 Health Insurance Portability and Accountability Act (HIPAA) Transaction 835v4010 Completion Update. September 5, 2002 HIPAA Institutional 837 Health Care Claims -DDE Updates - August 20, 2002 HIPAA Institutional 837 Health Care Claim Additional Implementation Direction - August 16, 2002 HIPAA Model Compliance Plan and Instructions – June 6, 2002 HIPAA Institutional 837 Health Care Claim-Hospice Direction HIPAA Institutional 837 Health Care Claim-Home health Direction – May 16, 2002 HIPAA Health Care Eligibility Benefit Inquiry/Response Transaction Standard – April 25, 2002 Revised Timelines for HIPAA – March 28, 2002 HIPAA Institutional 837 Health Care Claim Implementation Updates – March 7, 2002 HIPAA 837 Health Care Claim implementation – February 28, 2002 HIPAA Delay Q&A – February 14, 2002 Electronic Remittance Advice Changes for HIPAA – September 6, 2001 Health Insurance Portability and Accountability Act (HIPAA) Reminders – August 30, 2001 Notification to Providers and Suppliers of Transaction and Code Set Rule Promulgated In Accordance With the Health Insurance Portability and Accountability Act (HIPAA) – October 26, 2000 List of Providers who have Successfully Completed Testing to Submit HIPAA Claims Organizations Successfully Tested with CareFirst of Maryland – Medicare Part A May 16, 2003 Back to top
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