Leslie: You are correct in that banks are not automatically clearinghouses. However, banks can be clearinghouses and some are, in fact, positioning themselves in that role.
Our bank, for example, accepts standard 820s for us and converts these into an existing proprietary format used to send premium information to us today (for paper checks received). In fact, I have routinely recommended to other carriers that they consider using their banks for the same solution, since the 820 is a common transaction in the financial industry. Another bank I am aware of is trying to position itself to accept 835s for providers, match the data to electronic fund transfers and paper checks received from carriers, and feed this information to providers via whatever system or process the provider may use. This same bank has created the ability to send an 837 for providers, so that they can serve the provider on the whole claim process. Ken Fody Independence Blue Cross -----Original Message----- From: Leslie C. Bender [mailto:[EMAIL PROTECTED]] Sent: Wednesday, May 01, 2002 10:22 AM To: 'Drexler, Deborah'; [EMAIL PROTECTED] Subject: RE: Applying HIPAA to Banks? CE versus BA versus "conduit" I don't clearly see banks as clearinghouses (do the functions they perform actually rise to the definitional requirements under HIPAA for a healthcare clearinghouse?)-- but I can see a number of instances in which banks could be "business associates." Banks can be "business associates" particularly if they furnish lock box services, handle/receive ACH or other electronic transfers from payers on behalf of providers and there is any PHI on checks, correspondence or other remittance documentation that accompanies the payments. Several years ago there was a decided trend toward providers using lock box arrangements as a cost containment concept and as part of perhaps a larger commercial lending arrangement that gave added security to the lenders. Another financing vehicle that would result in the use or disclosure of PHI would be the securitization of patient accounts receivable when potentially a provider would "sell" its patient accounts receivable to a third party financier to raise capital and the third party would be responsible for collecting the receivables from patients or payers itself. In the smaller provider market, banks that handle all business banking relationships with smaller provider groups and offer cash flow financing (an asset or accounts receivable based line of credit) may also require periodic receivables agings that potentially contain patient names. Leslie C. Bender, Esq. -----Original Message----- From: Drexler, Deborah [mailto:[EMAIL PROTECTED]] Sent: Monday, April 29, 2002 4:26 PM To: [EMAIL PROTECTED] Subject: RE: questions on the appropriate way to reply when there are errors in a transaction request At the HIPAA summit in DC I just attended, there was talk of how the banking industry is just starting to realize that they have to be HIPAA compliant. Apparently banks are often clearinghouses and subject to the HIPAA rules. I didn't really understand much more than that. Deborah Drexler Privacy and Security Officer Division of Medical Assistance Boston, MA 02111 617-210-5372 [EMAIL PROTECTED] -----Original Message----- From: Meyers, Ed [mailto:[EMAIL PROTECTED]] Sent: Monday, April 29, 2002 3:44 PM To: '[EMAIL PROTECTED]'; Bill Chessman; [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: RE: questions on the appropriate way to reply when there are errors in a transaction request Well almost...... The Transaction regulation clearly requires some contractual relationship between the CE and the bank. However, page 50318, Federal Register dated August 17, 2002 states, "The administrative simplification provisions of HIPAA do not require non-covered entities to use the standards, but non-covered entities are encouraged to do so in order to achieve the benefits available from such use." The bank does not have to accept or process HIPAA compliant transactions. The bank cannot be out of HIPAA compliance at any time because they are not subject to HIPAA. The bank is subject to GLB privacy provisions for the data it has under its control. You as the CE will be OK if your contract spells out the needed HIPAA language. Edward Meyers Security Officer Missouri Department of Mental Health [EMAIL PROTECTED] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] Sent: Monday, April 29, 2002 2:25 PM To: Bill Chessman; [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: RE: questions on the appropriate way to reply when there are errors in a transaction request Would you not have to have a "Chain of Trust" relationship, and a Trust Partner Agreement with the Bank in question for all importation exchange? I think so. Without it, you are liable. So the simple answer is, the bank would have to be HIPAA compliant for all areas and systems that receive and use that identified information. Sounds like a new business opportunity for a smart bank! HIPAA Compliant Banking Services!!! Any Bank VP's listening out there? Anyone own bank stock who wants to write a letter to your bank CEO? Regards, Dr. Tim McGuinness, Ph.D. Sr. Compliance Specialist & Solutions Architect Certified HIPAA Chief Privacy Officer DynTek Inc. www.dyntek.com -----Original Message----- From: Bill Chessman [mailto:[EMAIL PROTECTED]] Sent: Monday, April 29, 2002 1:31 PM To: '[EMAIL PROTECTED]' Subject: RE: questions on the appropriate way to reply when there are errors in a transaction request This may not be the right place to ask this question (and it might not even be reasonable or valid), but since the thread is running here, I might as well throw it out: If an 835 contains patient information (even the patient name) is sent to an organization not required to be HIPAA compliant, isn't it a violation of the patient's privacy rules? The bank may not use the information, but since it's in the transaction, it is visible to a (theoretically) unauthorized party. Best regards, Bill Chessman Peregrine Systems, Inc. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. 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