Providers are not REQUIRED to send transactions electronically. But, the privacy rules apply to electronic, verbal and written communications. The provider must comply with the privacy regs.
I have a clarification question. Others here have stated that a provider must send HIPAA transaction if they send electronically. My understanding is that a provider had to send these transactions if they want the government to help them force the payer/TPA/TPO to accept EDI transactions. But, the provider and the payer/TPA/TPO could agree to send other formats. That is, if a provider is sending NSF claim files to a payer there is no requirement to change if the payer continues to support it. From a practical standpoint the payer could stop supporting the NSF format and the provider would have to change if it wishes to continue to send EDI. But it is not REQUIRED to do so. Mr. Tracy A. Mitchell Director Information Services Arizona Foundation for Medical Care -----Original Message----- From: Heiert, David [mailto:[EMAIL PROTECTED]] Sent: Friday, February 15, 2002 11:07 AM To: '[EMAIL PROTECTED]' Subject: RE: Must providers/billers comply with all formats Well, based on this discussion, I have to raise another question... If provider and payer are not required to exchange data electronically EVER, can all of the information exchange be done via phone, fax, etc? If so, that would mean that none of the HIPAA standardization and privacy rules are going to apply... Is that true? I don't remember seeing anything that MANDATES that private insurance agencies and private providers are required to exchange data electronically... as well. ********************************************************************** 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.
