Not true... Simply put; It is essentially impossible for a payer NOT to be subject to HIPAA because they are required to accept a standard transaction if a provider wants to submit one. A provider however can make themselves not subject to any of the HIPAA provisions as long as they DO NOT PERFORM ANY OF THE "NAMED" (More could be added) TRANSACTIONS 834, 820, 270, 271, 278, 837, 276, 277, 835, NCPDP
Eddie G. Anderson 204 Blue Crab Cove Emerald Isle, NC 28594 Phone 252-354-5111 Fax 866-286-8038 email [EMAIL PROTECTED] -----Original Message----- From: Sayman,William [mailto:[EMAIL PROTECTED]] Sent: Friday, February 15, 2002 3:31 PM To: '[EMAIL PROTECTED]' Subject: RE: Must providers/billers comply with all formats Covered entities are required to use standard transactions. � 162.923 Requirements for covered entities. (a) General rule. Except as otherwise provided in this part, if a covered entity conducts with another covered entity (or within the same covered entity), using electronic media, a transaction for which the Secretary has adopted a standard under this part, the covered entity must conduct the transaction as a standard transaction. -----Original Message----- From: Tracy A. Mitchell [mailto:[EMAIL PROTECTED]] Sent: Friday, February 15, 2002 1:57 PM To: [EMAIL PROTECTED] Subject: RE: Must providers/billers comply with all formats 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. ********************************************************************** 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. ********************************************************************** 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.
