I would suggest Claredi. They are the testing (certification) provider that Medicare is requiring us to use.
Dave Lounsberry Electronic Commerce Blue Cross Blue Shield of Nebraska [EMAIL PROTECTED] 402-548-4423 ------------------( Forwarded letter 1 follows )--------------------- Date: Mon, 11 Feb 2002 12:38:45 -0700 To: [EMAIL PROTECTED] From: Denise.Bruno[dbruno]@uraonline.com Sender: [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] Subject: RE: Compliance tools 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 ---------------------------------------------------------------------------- -- Do You Yahoo!? Send FREE Valentine eCards with Yahoo! 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