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- HIPAA TRANSACTIONS AND CODE SETS UPDATE
HIPAA TRANSACTIONS AND CODE SETS UPDATE
Mario Tedesco, from the NYS Department of Health, in a phone conference with the MRDD HIPAA Task Force, mentioned that:
1. Fewer than 20% of Medicaid claims are compliant with HIPAA transaction and code set standards. Certain errors being seen in submission of HIPAA-compliant Medicaid transactions are the same errors that have occurred in the past with non-HIPAA claim submissions.
2. The State Department of Health (DOH) will review the numbers of HIPAA-compliant Medicaid claims being submitted before determining when to impose a deadline for submission of only HIPAA-compliant Medicaid claims. A DOH status review will likely occur in June 2004.
3. DOH continues discussions with Medicaid vendors who process a large volume of Medicaid claims (e.g. WebMD, Siemens) to work on technical and other issues that need to be resolved so that testing of claims submissions from these vendors can begin. DOH is concerned about lack of reports about whether progress is being made by providers (physician practices in particular) who submit only a small volume of Medicaid transactions.
4. To monitor progress, DOH regularly receives claim submission data from Computer Science Corporation(CSC). Steve Beauchemin of CSC noted that, within a day or two, providers and vendors will be able to access information [by their "TSN" number(s)] about Medicaid claims that have either been denied or are pending. This information will be available at: https://www.nyhipaadesk.com. This same website will also include help pages that list the most common reasons why a transaction has failed an edit, with hyperlinks to solutions for edit problems. The "frequently asked questions" section of the website has been updated to include information about problems with adjustments and "voids".
5. Vendors and providers who continue to have problems with transactions can call CSC to talk to a representative. There have been some difficulties getting answers from CSC in the past, and CSC still has some claims adjudication problems to resolve.
6. ePACES software, designed for use by providers with a small volume of Medicaid claims, is being used successfully by a number providers and vendors.
NYSACRA will keep you posted about the status of HIPAA compliant transactions. |
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