Cindy-- You sent two questions concerning interpretations of the Transactions Final Rule to the WEDI SNIP Transactions listserv. You might want to check out the HHS Administrative Simplification web site's Frequently Asked Questions. The web site is: http://aspe.os.dhhs.gov/admnsimp/ If your questions are not already answered in those FAQs, you should submit them to the FAQ mailbox available at that address.
(I accessed the web site a few minutes ago. Unfortunately, there seems to be a problem affecting the ability to send questions to that mailbox! I will inform the people who maintain the web site of this problem so they can resolve it.) >>> [EMAIL PROTECTED] 10/16/01 04:39PM >>> As a provider of LTC, we fall under the "covered entity" description in the HIPAA regs. Obviously we have to be compliant with the Transactions Standards for 837's and 835's, but I am uncertain about the below two scenerios that deal with employee comp claims and benefits plans. 1. Some of our centers have TPA's that handle our workmens' comp claims. Are we required to have something in our contract with them that references HIPAA compliant verbiage. ( This more than likely deals more with the privacy regulation). 2. We are self-insured but contract with a TPA to administer our employee benefits program. Does our contract with them need to reference HIPAA verbiage? When we transmit info to and from our TPA that contain this benefit info do we need to transmit it the appropriate ANSI X12 format or do the Transaction Standards not apply in this situation? Any assistance you can provide would be helpful. Cindy M. Nielsen Department Director, Information Security Good Samaritan Central Office Phone: 605-362-3252 Fax: 605-362-3991 email [EMAIL PROTECTED] ********************************************************************** 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. ********************************************************************** 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.
