After November 15, 2003, Providers still have the option of submitting claims on 
paper, but health plans must accept standard transactions from providers if the 
provider chooses to submit claims electronically.  If the provider submits 
electronically it must be in the standard format and content.  Health plans and 
providers may use healthcare clearinghouses to assist them if they so choose.

The risk to the provider of submitting paper claims is that they may not be paid as 
quickly as they would if they submitted electronically.  

The plan not being compliant should be a red flag to the provider.  The plan is facing 
fines, possible prison for executives who ignored the law and the providers timely 
payment for claims is at risk.

John Sherman
HIPAA Project Manager
Corporate Benefit Services of America
(952)593-6478 Fax (952)582-2849
[EMAIL PROTECTED]  

-----Original Message-----
From: Brenda K. Burton [mailto:[EMAIL PROTECTED]
Sent: Wednesday, June 04, 2003 10:20 AM
To: WEDI SNIP Transactions Workgroup List
Subject: Payors not compliant effective on provider



Please, if somebody could clarify/refer me to the answer (I'm sure this has been 
dicussed):

If a payor is unable to handle electronic transactions by October 16, may they revert 
to paper unilaterally?  

What other A/R risks are present for the healthcare provider if a particular payor is 
not able to be compliant by October 16?

Looking for contingency planning reasons.

Thanks!
Brenda


Brenda K. Burton
MEDEXTEND
877-491-7650

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The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions 
on this listserv therefore represent the views of the individual participants, and do 
not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If 
you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
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