We currently out-source our mail handling to an outside vendor. One of the things
they do for us is to key paper claims that have been mailed to us into our "translated
EDI" format and send them to us for processing. In this instance we have received
paper claims from the provider/subscriber and NOT EDI.
Questions have come up:
- Are they required to send us HIPAA compliant formats?
- Are they considered to be a "clearing house" so we can continue to
receive non-compliant translated data from them?
- Is this data not covered at all (from a transaction code set / EDI
perspective) because we have received paper claims and are using
external/internal resources to convert them to an electronic format for auto-
adjudication?
- Other options/opinions?
I think we understand how this practice is affected by the privacy and security pieces.
Thank you.
[EMAIL PROTECTED]
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