If this is the case and no loophole exists for small providers,)and we are
currently sending electronic claims to Medicare and a number of other
payers), does anyone have a recommendation for a vendor for testing and
certification?
Thanks everyone.

-----Original Message-----
From: Claudia J. Egan [mailto:[EMAIL PROTECTED]]
Sent: Monday, February 11, 2002 10:20 AM
To: '[EMAIL PROTECTED]'
Subject: RE: Compliance tools



It's not a myth, however, that if a provider does not submit claims
electronically, that provider need not comply with the Transaction Rule or
Privacy Rule under HIPAA.  By requiring electronic transmission to Medicare,
the Act pushes all participating providers over the size limit to electronic
submission, and thus, to compliance with the Privacy Rules and Transaction
Rules.  I don't know if there was a large practice that was planning to
continue paper processing, but the Act forecloses the option!


-----Original Message-----
From: Sadauskas, Thomas, CON, OASD(HA)/TMA
[mailto:[EMAIL PROTECTED]]
Sent: Monday, February 11, 2002 10:57 AM
To: '[EMAIL PROTECTED]'
Subject: RE: Compliance tools


I think he may have gotten this confused with the provisions of the recent
H.R. 3323, Administrative Simplification Compliance Act.

The Act includes a reference granting a waiver for a "small provider of
services or supplier" from having to submit Medicare claims electronically.


The term "small provider of services or supplier" is defined as:

A provider of services with fewer than 25 full-time equivalent employees or
a physician , practitioner, facility or supplier (other than provider of
services) with fewer than 10 full-time equivalent employees.

This "loophole" ONLY applies to the electronic submission of Medicare
claims.

Perhaps this is how "Urban Myths" begin.

Tom Sadauskas, FHFMA, CHE, CPA
Northrop Grumman Information Technology
703-575-0119  Fax - 703-575-0215
[EMAIL PROTECTED]


-----Original Message-----
From: Leah Hole-Curry [mailto:[EMAIL PROTECTED]]
Sent: Monday, February 11, 2002 11:02 AM
To: [EMAIL PROTECTED]
Subject: RE: Compliance tools


Could you cite a page or provision number for reference?  You are
probably reading in another subchapter of HIPAA, perhaps related to the
portability portion of the act, not the administrative simplification
part.

Leah Hole-Curry
Fox Systems, Inc.

>>> [EMAIL PROTECTED] 02/11/02 06:23 AM >>>
I am the compliance and billing manager for a group of 28 physicians.  I
was
reading in the Administrative Simplification Act that a 25 full-time
employee or less organization need not comply to the act.  Our
organization
fit in the 25 or less category.  Did anyone else see, read, or have more
information about this loophole?


  -----Original Message-----
  From: mbt [mailto:[EMAIL PROTECTED]]
  Sent: Friday, February 08, 2002 1:22 PM
  To: [EMAIL PROTECTED]
  Subject: Compliance tools





  I need recommendation on evaluation tools for Transaction Standards
and
Code Sets to determine compliance.  I would prefer free off the web if
possible and links to suggested products for purchase.



  Margaret Taylor

  President

  CIAGA, LLC


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