Rx2000HIPAA Digest, Volume 4 #1 From: MC1959@aol.com Subject: Re: Hcfa 1500 and UB92 #2 From: medimage@voicenet.com Subject: Re: HIPAA billing standards #3 From: RMeinhardt@foleylaw.com Subject: RE: HIPAA billing standards #4 From: michelle.chaudry@mcleodcg.com Subject: RE: HIPAA billing standards #5 From: RTelesca@gigaweb.com Subject: RE: HIPAA billing standards #6 From: mmbm@thegrid.net Subject: medicare fraud #7 From: Petehc@aol.com Subject: Re: HIPAA billing standards #8 From: Sslazarus@aol.com Subject: Re: HIPAA billing standards ********** Message #1 ********** From: MC1959@aol.com To: Rx2000HIPAA@rx2000.org Subject: Re: Hcfa 1500 and UB92 Date: Fri, 24 Mar 2000 14:00:08 EST Michelle: That's the "gotcha" that they do not appear to address. Presumably you would be on your own to get required data to the intermediary/claims processor any way you and they agree upon (the interemdiaryy/processor would most likely develop some forms/templates to follow). HCFA's goal is to encourage everyone to move towards electronic transactions, but leave some wiggle room for those who can/will not do it themselves Mike Cohen MRC Consulting Group (630) 653-9242 MRCCG@aol.com www.MRCCG.com In a message dated 3/24/00 12:14:56 PM Central Standard Time, Rx2000HIPAA@rx2000.org writes: << My question is the new electronic format requires additional information that is not currently captured on the UB92- HCFA 1500. How will the current forms address the missing new data requirements? Even with the intermediary converting the forms into an electronic format they must somehow receive all of the required information. >> ********** Message #2 ********** From: medimage@voicenet.com To: Subject: Re: HIPAA billing standards Date: Fri, 24 Mar 2000 13:58:31 -0500 ---------- > From: Rx2000HIPAA@rx2000.org > To: Rx2000HIPAA@rx2000.org > Subject: HIPAA billing standards > Date: Thursday, March 23, 2000 3:53 PM > > > Has anyone heard that Workers Comp and Auto No-Fault carriers are not > subject to HIPAA billing standards? > Stewart Presser > Vice President > Greater New York Hospital Association Can't help you regarding Worker's Comp or Auto No-Fault but your question brings up another potential question. Should not industries that aquire, transmit, share, exchange, and archive personally identifiable medical information for the purpose of marketing and promotion of their industry's products or services be held to the same HIPAA regulations and subsequent IT/security costs? dk > > Stewie > > ********** Message #3 ********** From: RMeinhardt@foleylaw.com To: "'Rx2000HIPAA@rx2000.org'" Subject: RE: HIPAA billing standards Date: Fri, 24 Mar 2000 13:42:28 -0600 Apparently that's true. The proposed regulation itself makes no mention of workers' comp insurance in the definition of "health plan", but could be interpreted to include WC, auto insurance carriers and other property and casualty insurers under the "plan that provides, or pays the cost of, medical care" language in the health plan definition. However, HHS states in the preamble that this does not include WC or auto insurers. Hopefully they'll make that explicit in the final regulations. Robyn A. Meinhardt Foley & Lardner Denver, CO 303-294-4414 > -----Original Message----- > From: Rx2000HIPAA@rx2000.org [SMTP:Rx2000HIPAA@rx2000.org] > Sent: Thursday, March 23, 2000 1:53 PM > To: Rx2000HIPAA@rx2000.org > Subject: HIPAA billing standards > > > Has anyone heard that Workers Comp and Auto No-Fault carriers are not > subject to HIPAA billing standards? > Stewart Presser > Vice President > Greater New York Hospital Association > > Stewie > > ********** Message #4 ********** From: michelle.chaudry@mcleodcg.com To: Subject: RE: HIPAA billing standards Date: Fri, 24 Mar 2000 14:46:50 -0600 Stewie, Workers Compensation: The HIPAA definition of a health plan does not specifically include Workers Compensation programs or carriers. However, the list of designated transactions for which the Secretary must adopt standards for electronic transmission includes "First Report of Injury" which is the primary transaction used to initiate Workers Compensation actions. For this reason, the Secretary will be proposing a standard for First Report of Injury and will be considering different ways of achieving compliance with this standard. Hope that helps, Michelle Chaudry, MIS, RHIA McLeod Consulting Group, Inc. Advisory Consultant 708-862-5029 Michelle.Chaudry@McLeodCG.com -----Original Message----- From: Rx2000HIPAA@rx2000.org [mailto:Rx2000HIPAA@rx2000.org] Sent: Thursday, March 23, 2000 2:53 PM To: Rx2000HIPAA@rx2000.org Subject: HIPAA billing standards Has anyone heard that Workers Comp and Auto No-Fault carriers are not subject to HIPAA billing standards? Stewart Presser Vice President Greater New York Hospital Association Stewie ********** Message #5 ********** From: RTelesca@gigaweb.com To: "'Rx2000HIPAA@rx2000.org'" Subject: RE: HIPAA billing standards Date: Fri, 24 Mar 2000 16:06:29 -0500 The current language indicates they are not covered by the standards. According to the Standards for Electronic Transactions "plans such as property and casualty insurance plans and workers compensation plans, which may pay health care costs in the course of administering nonhealth care benefits, are not considered to be health plans in the proposed definition". However, the proposal also points out that at some time in the future, Congress may choose to include these in the list of covered entities. Rick Richard J. Telesca ePractices Research Giga Information Group 54 Lavender Lane Rocky Hill, CT 06067 860.257.8527 (phone) -----Original Message----- From: Rx2000HIPAA@rx2000.org [mailto:Rx2000HIPAA@rx2000.org] Sent: Thursday, March 23, 2000 3:53 PM To: Rx2000HIPAA@rx2000.org Subject: HIPAA billing standards Has anyone heard that Workers Comp and Auto No-Fault carriers are not subject to HIPAA billing standards? Stewart Presser Vice President Greater New York Hospital Association Stewie ********** Message #6 ********** From: mmbm@thegrid.net To: Subject: medicare fraud Date: Sat, 25 Mar 2000 17:01:01 -0800 could you please give me you input on the law that is now holding coders = and billers l responsible is Medicare find fraud in the billing even if = the coders and billers or not a party to any fraud just poor billing = practices, also could you give me the name of the law and were it can = be found my administer thinks I'm making this up about who is liable Mary M mmbm@thegrid.net ********** Message #7 ********** From: Petehc@aol.com To: Rx2000HIPAA@rx2000.org Subject: Re: HIPAA billing standards Date: Sun, 26 Mar 2000 20:32:15 EST According to something I saw in the NCCI wegsite, whereas the preamble of HIPAA states it is not applicable to Workers Compensation, NCCI is concerned that the regulations could drive Workers Compensation in HIPAA. NCCI is the National Association of Workers Compensation Carriers. I know nothing about the Auto side. Pete Biagioitti Aon 818-363-9435 ********** Message #8 ********** From: Sslazarus@aol.com To: Rx2000HIPAA@rx2000.org Subject: Re: HIPAA billing standards Date: Sun, 26 Mar 2000 16:28:27 EST The later are definitely accountable directly under the Security NPRM. The privacy NPRM suggests that specific patient authorization would be required for each release for these purposes and the covered entity would be accountable under the Business Partner provisions. Of course, the finals rule could be different. Steve Lazarus, PhD, FHIMSS President Boundary Information Group and Chair-Elect WEDI 303-488-9911 sslazarus@aol.com