Perhaps one way to think about this is that HIPAA does not mandate that provider submit any transaction electronically. However, PAYERS are free to make a business decision to mandate this.
For example, Utah Medicaid mandated that all institutional claims come in electronically over a year ago. If an institutional provider sends them a paper claim, Medicaid puts it back in the envelope and politely tells the provider to resubmit the claim electronically. Of course, in order to do this Medicaid had to first get ride of all their requirements for attachments for an intsitutional claim. They accomplished this and now, instead of getting paper claims with a lot of attachements, they do back-end audits on questionable claims. It has turned out to be a lot cheaper than handling all the paper. Payers still have a lot of latitude to make business decisions about transactions. j Amanda Dorsey wrote: > I hope this is the appropriate group with whom we would share a lingering question. > One of our assessment working groups has an ongoing debate on whether providers >have a choice in their claims-submission method. We have two groups who interpret >the regs two ways and one group that maintains this isn't specifically addressed in >the regs at all. Our question is: > > Once a provider has submitted a transaction electronically to a payer, does the >provider always have to send that transaction electronically? > > We gratefully appreciate anyone's answer or thoughts on this question. > > Regards, > Amanda > > ********************************************************************** > To be removed from this list, send a message to: [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request.
begin:vcard n:Root;Jan tel;fax:801-466-7169 tel;work:801-466-7705 x202 x-mozilla-html:FALSE org:Utah Health Information Network version:2.1 title:Standards Manager adr;quoted-printable:;;1939 South 300 West=0D=0ASuite 186-11;Salt Lake City;Ut;84115; x-mozilla-cpt:;21136 fn:Jan Root, Ph.D. end:vcard ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request.
