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HIPAA requires the use of specific national standards
for the electronic transmission of
health care claims. The compliance deadline for the electronic
transactions regulation was
October 16, 2003. NovaSys Health is implementing a contingency
plan as permitted by
Centers for Medicare and Medicaid Services (CMS) to help ensure
that claim payments
remain uninterrupted to our providers.
Upon receiving a significant number
of inquiries expressing concern over the health care
industry’s state of readiness CMS issued official guidance
on July 24, 2003, regarding
compliance with the transaction rule (www.cms.hhs.gov/hipaa/hipaa2).
CMS would like
to avoid claims payment delays caused by providers reverting
to paper submissions.
Per CMS’s official guidance,
payers may choose to deploy contingency plans to maintain
the flow of claim payments during the period immediately following
October 16, 2003.
Providers who are making a "good-faith" effort to
become HIPAA-compliant may
continue submitting nonstandard electronic claims for a limited
time, until they are able
to become compliant with the transactions rule. If your organization
is testing claims
submission in the HIPAA format and have made reasonable and
diligent efforts to
become compliant, NovaSys Health will continue to accept your
NSF claims after the
compliance deadline.
Providers may use a clearinghouse
to convert their nonstandard electronic claims to
standard before transmitting that data to the appropriate
payer. WebMD and Gateway
EDI are HIPAA clearinghouses that providers may use to submit
claims to NovaSys
Health. If you are ready to test HIPAA-compliant claims directly,
through a third party,
or wish to select one of the above vendors as your clearinghouse,
please contact EDI
Services at 501-219-4451 or toll free at 800-294-3557 ext.
451.
NovaSys Health plans to continue
to accept your non-compliant claims for approximately
six months to avoid disruption of your cash flow during this
transition to HIPAA
standards. During this interim period, we will continue to
accommodate providers in
"good-faith" testing.
We do, however, reserve the right
to decline to accept non-compliant claims at our
discretion on a case-by-case basis. If you have questions
or need assistance regarding
HIPAA compliance, please contact our HIPAA Office at 501-219-4603.
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