Claudia,

In your message you neglected to also note that providers who only
submit paper claims, but use a billing service that conducts
transactions electronically, would still be covered under HIPAA.  One
cannot avoid HIPAA compliance via the use of a business associate.

David F Walter

"Claudia J. Egan" wrote:
> 
> 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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