I think the max penalty is $25K for TCS violations-  I think the criminal
penalties may be for Privacy and Security violation- any lawyers out there?

-----Original Message-----
From: John Sherman [mailto:[EMAIL PROTECTED]
Sent: Wednesday, June 04, 2003 11:52 AM
To: WEDI SNIP Transactions Workgroup List
Subject: RE: Payors not compliant effective on provider


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

Join us for discussion at:
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