If a provider is using software to send claims electronically and that
software is not HIPAA compliant, the provider is in violation of HIPAA
regardless of where the software came from and which payer they send to
with it.  Many providers will have to weigh the risk of potential
non-compliance against the cost.  For some, resource limitations might
require that they accept the risk that a payer's software is not fully
compliant and focus instead on the system they know for certain is not
compliant.  One size plan does not fit all and each provider needs to
weigh the risk themselves.

Marcallee Jackson
Long Beach, CA
562-438-6613

-----Original Message-----
From: Mimi Hart [mailto:[EMAIL PROTECTED]] 
Sent: Friday, October 11, 2002 6:02 AM
To: [EMAIL PROTECTED]
Subject: RE: Payer Provided Software and HIPAA Compliant Claims

I am hoping to get answers from those who are currently in the testing
or production trenches on this question.

If you are using payer provided software (such as Medicare software) to
submit your claims to that payer only, please don't flame me here....but
does the claim have to be 100% compliant? Do you have to complete full
due diligence testing when you are using payer provided software to
submit to that payer only? Isn't the due diligence on their side to make
sure their software is 100% Wouldn't your resources be better spent on
the third party system you are using to send claims to 100+ payers? Just
wondering...

Mimi Hart ӿ�*
Research Analyst, HIPAA
Iowa Health System
319-369-7767 (phone)
319-369-8365 (fax)
319-490-0637 (pager)
[EMAIL PROTECTED]
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