Jan,
It has been a while since we have talked.
Very interesting method of getting rid of paper. What did it take to
move in this direction? Did the medical society raise holy heck when
this came up?
Regards,
- Holt
-----Original Message-----
From: Jan Root [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, October 09, 2001 5:43 PM
To: [EMAIL PROTECTED]
Subject: Re: Once electronic, always electronic?
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
>
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