A few weeks ago, I (essentially) asked the question:  "if a Business Associate
accepts paper claims from its Plan-client's providers (on behalf of the
Plan-client); then scans and (essentially) creates electronic data (OCR data)
from that paper - for subsequent claim adjudication & payment - does that make
it a HIPAA Clearinghouse"?

 

The resulting discussion was very enlightening - but the overall verdict was
NO: although the Rule is a tad ambiguous in this area; the overwhelming
presumption is that a Clearinghouse must be working with electronic data on
BOTH the INPUT and OUTPUT side to BE a HIPAA Clearinghouse.

 

The above seems to be supported in several papers (including  a SNIP white
paper) and CMS as well.

 

SECOND QUESTION (a bit trickier):

 

Again, I'm a Business Associate of a HIPAA Plan (several, actually).  

 

Today, for one client; I actually log on to a commercial clearinghouse  (the
biggest one; name begins with a "W") - and I FTP down every day a claims file.

 

These claims are, again, filed by my Plan-client's providers.  

My Plan-client pays "W" for clearinghouse fees (subscription fee, transaction
fees, etc.).  

I take this claims file; and use my own EDI translator to load into claims
payment software that I operate on behalf of my Plan-client.

I pay the claims (both paper and electronically submitted) for my Plan-client.
 [I'm not at medical dollar risk - this is admin services only].

 

Here's the question:  Am I, in the above capacity, operating as a HIPAA
Clearinghouse?  (at least on 10/2003; with extension). 

 

ARGUMENT FOR:  Well, I AM accepting claims electronically; and I am
reformatting them.  

 

ARGUMENT AGAINST:  Well, the PLAN is paying the Clearinghouse; so the PLAN can
insist that the Clearinghouse send claims in a format other than the HIPAA 837
to me (on their behalf).  In this sense, I'm just; well ... a Business
Associate of the PLAN; representing it's operations.  In this sense, there is
no difference than if the Clearinghouse were to send these claims DIRECTLY to
the PLAN.



What do you think?






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