Kathy,
I think a lot of these 'sticky' questions will probably get resolved as
the implementation dates get closer.  I think each milestone requires
industry input and it is too much of a task to do it all at once.

Regards,

David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
www.gefeg.com
425-260-5030

-----Original Message-----
From: Carlin, Kathy (Contractor) [mailto:[EMAIL PROTECTED]] 
Sent: Thursday, October 10, 2002 10:29 AM
To: '[EMAIL PROTECTED]'
Subject: RE: HIPAA Exemption

Hi David, 

What is Medicare planning for secondary Medicare professional service
claims
submitted to Medicare after 10/16/03; however, the primary claim was
submitted prior to implementation of the 837P?  If the primary payer did
not
return an 835 with the required elements for 837 electronic billing due
to a
timing issue, the provider will not be able to submit the secondary
claim
electronically to Medicare.  


Thank you,

Kathy Carlin, Principal Consultant
Siemens Medical Solutions


UCLA Phone 310-301-5219
UCLA email:  [EMAIL PROTECTED]
Siemens Voicemail 610-219-2067
Siemens email:  [EMAIL PROTECTED]

 -----Original Message-----
From:   David Frenkel [mailto:[EMAIL PROTECTED]] 
Sent:   Thursday, October 10, 2002 10:16 AM
To:     [EMAIL PROTECTED]
Subject:        RE: HIPAA Exemption

>From the CMS FAQ:

ASCA prohibits HHS from paying Medicare claims that are not submitted
electronically after October 16, 2003, unless the Secretary grants a
waiver from this requirement. It further provides that the Secretary
must grant such a waiver if there is no method available for the
submission of claims in electronic form or if the entity submitting the
claim is a small provider of services or supplies. Beneficiaries will
also be able to continue to file paper claims if they need to file a
claim on their own behalf. The Secretary may grant such a waiver in
other circumstances. We will publish proposed regulations to implement
this new authority.

Regards,

David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
www.gefeg.com
425-260-5030

-----Original Message-----
From: Aaron Johnson [mailto:[EMAIL PROTECTED]] 
Sent: Thursday, October 10, 2002 10:03 AM
To: [EMAIL PROTECTED]; Alex Kaplun
Subject: RE: HIPAA Exemption

After reading your responses to Jonathan, I think you should rethink
your answer.  Here is the real answer, check it out, let me know if you
have any questions.

Jonathan,

No, Medicare and just spent $78 Million to upgrade their system and
applications, and will not accept paper claims after October of next
year.  There is a lot about HIPAA you need to know, transmitting claims
is just a very small piece of the HIPAA pie.  I would start reading and
searching on the web.  This is not an overnight process, its not even an
over a couple of weeks process, so get educated.  HIPAA has introduced
over 80,000 ways to be incompliant, with fines up to $25,000 for each.
You have to remember, your dealing with civil rights issues.  Our team
is already helping practices whip the HIPAA thing.  I am not sure where
you are located geographically but let me know, maybe we can help.  Good
Luck.  Check out these sites, maybe they will help you get a start:

www.hhs.gov/ocr/hipaa/index.html
www.jcaho.org
http://fortress.wa.gov/dshs/maa/dshshipaa/

Aaron Johnson
e-Solutions Manager, CSI
office: 904.794.5044 x370
cell:   904.669.5590
4475 South US 1, suite 100
St. Augustine, FL  32086

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