HIPAA Help From CMA
Help Us Help You with HIPAA Billing Problems
The number of calls CMA is receiving from physicians having HIPAA-related billing problems is increasing. If your practice files claims electronically and does not use a billing service, please take a few minutes to fill out a brief questionnaire so that CMA can better understand the extent of these problems and develop tools to assist physician offices during this HIPAA transition period. [Posted 11/20/03 ]
How to Report HIPAA-Related Payment Hassles
Physicians having trouble with health plans, clearinghouses, or others who are not yet in compliance with HIPAA's transactions and code sets rule can file an anonymous complaint through AMA's online HIPAA Complaint Form.
[Posted 10/30/03 ]
The HIPAA Electronic Transactions Deadline Is Here. Now What?
The HIPAA Transactions and Code Sets Rule deadline has finally arrived. Is your practice ready to begin submitting HIPAA-compliant standard transactions? If not, you're not alone.
[Posted 10/16/03 ]
Medicare Contingency Plan Does Not Mean Physicians Can Relax HIPAA Compliance Efforts
The Centers for Medicare & Medicaid Services announced last week that it will continue to accept noncompliant electronic transactions after the October 16 deadline. [Posted 10/02/03 ]
New Medi-Cal Procedure Codes Took Effect Sept. 22
Medi-Cal providers should have begun using Medi-Cal's new procedure codes on September 22, as part of phase one of the program's HIPAA implementation plan. The previous local codes have been discontinued. [Posted 10/02/03 ]
Debunking the "County Doctor" Exemption
Many people are touting the "Small Practice" or "Country Doctor" exemption as a way for providers to escape HIPAA compliance. Please note – THERE IS NO SUCH EXEMPTION. [Posted 08/28/03 ]
New Member Benefit: HIPAA-Compliant Claims Submission
CMA has partnered with Infinedi, a Tulsa , Okla. , electronic clearinghouse, to ensure your practice's cash flow is not interrupted by new HIPAA mandates, which take effect, October 16. [Posted 07/24/03 ]
Download CMA's HIPAA Transactions Checklist
Do you currently send electronic claims to a clearinghouse? Does your billing service send electronic claims to a clearinghouse or directly to a payer on your behalf? If you answered "yes" to either of these questions, do you know if the company submitting your claims has been certified by nationally recognized firms specializing in evaluating HIPAA transactions compliance, such as Claredi or Edifecs? [Posted 07/31/03 ]
CMS Offers HIPAA Transactions Guidance, Holds to Deadline
Responding to the health care industry's concern about HIPAA readiness, the Centers for Medicare & Medicaid Services (CMS) this week issued its "Guidance on Compliance with HIPAA Transactions and Code Sets." [Posted 07/31/03 ]
HIPAA Transaction Rule Primer for Physicians
CMA ON-CALL Document #1606, "HIPAA Electronic Transaction Rule," provides a step-by-step guide so that physician offices can prepare to send HIPAA-compliant claims by the October 16 deadline. [Posted 07/10/03]
HIPAA Transactions: 10 Steps to Compliance
HIPAA's administrative simplification requirements will revolutionize the business of health care. Are you ready to take the next hurdle? [Posted 06/05/03 ]
Confused About HIPAA's Transaction Requirements?
If you're not up to speed on HIPAA's electronic transactions and code sets rule, you're not alone. Fifty-three percent of CMA members responding to our HIPAA survey do not understand what they need to do to transmit HIPAA-compliant claims by the October 16 deadline; 24 percent have not communicated with their software vendor or billing service about their ability to conduct electronic transactions by the deadline; and 21 percent were unaware that health plans may reject noncompliant claims after October 16. [Posted 05/29/03 ]
Will You Get Paid After October 16?
CMA is receiving reports of physicians paying large fees to upgrade their billing systems, only to be told that they still have to use a clearinghouse whose transaction charges have increased. This is because many billing systems vendors own (or are owned by) clearinghouses. It is important that physicians carefully evaluate new or upgraded billing systems before making a decision that could have a huge financial impact on their practices. [Posted 05/22/03 ]
HIPAA Tip: Hospital Staff Training Requirements
Physicians who have privileges at several hospitals complain that they are being required to complete the same HIPAA training at each hospital. The privacy rule is somewhat ambiguous as to the relationship between medical staff members and their hospitals. [Posted 05/14/03 ]
Survey: Help Us Help You With HIPAA
As more HIPAA deadlines approach, CMA will be ready to help physicians prepare for and comply with all HIPAA requirements. To help CMA best meet your educational and informational needs, please complete and return this brief survey. [Posted 05/14/03 ]
Do Not Procrastinate: Start Testing HIPAA Transactions Now
NHIC, California 's Medicare carrier, reports that 25 percent of California physicians are sending in their Medicare claims using the new HIPAA-compliant standard transaction formats. As of October 16, all physician practices that employ 10 or more full-time-equivalent employees (including physicians) must bill Medicare electronically. Those electronic billings must be HIPAA-compliant or Medicare will reject them. [Posted 05/08/03 ]
Appeals Court Rules: HIPAA Is Constitutional
On April 25, the federal Fourth Circuit Court of Appeals in Richmond, Va., upheld a trial court's ruling that the 1996 HIPAA legislation did in fact give the U.S. Department of Health & Human Services (HHS) the proper authority to create and enforce health care privacy regulations. [Posted 05/08/03 ]
HIPAA Tip: Privacy and Workers' Comp
Congress excluded workers' comp carriers, including self-insured employers and administrative agencies, when it passed the Health Insurance Portability and Accountability Act (HIPAA). Even so, physicians covered by HIPAA must still safeguard the protected health information of their workers' comp patients when transmitting it to entities that are not covered by HIPAA. [Posted 05/01/03 ]
Don't Let the Next HIPAA Deadline Disrupt Your Cash Flow
The next HIPAA deadline is fast approaching. Physicians have less than six months to prepare for compliance with HIPAA's electronic transactions and code-sets rule, which standardizes claims submission, processing, and payment. Physicians' billing system upgrades should already be well under way. [Posted 05/01/03 ]
HIPAA Tip: The Privacy Rule and Public Health Reporting
To protect the public from the spread of infectious, contagious, and communicable diseases, physicians are required by law to report such diseases to their local health department. HIPAA's privacy rule does not eliminate these public health surveillance requirements. [Posted 04/24/03 ]
CMA's HIPAA-Privacy-Rule Training Manual for Physician-Office Staff
HIPAA requires that all medical office staff be trained on how to comply with HIPAA's privacy rules. A Commitment to Privacy: The HIPAA Privacy Rule Training Manual —a joint effort of CMA, CAP-MPT, and PrivaPlan Associates, Inc.—provides the general training and overview necessary for office staff to fulfill that requirement. [Posted 04/17/03 ]
Notice of Privacy Practices Template Available in Spanish
A Spanish-language version of PrivaPlan's Notice-of-Privacy-Practices template will be available free to members through CMA's ON-CALL system (document #1604).[Posted 04/03/03 ]
HIPAA Tip: Notice of Privacy Practices
HIPAA requires that beginning April 14, all physicians with "direct treatment relationships" provide their patients with a written notice of the privacy practices they use to protect patients' health information. [Posted 04/03/03 ]
HIPAA Tip: FAQ About OHCAs
My hospital says I am in its "OHCA." What does that mean? An OHCA, or organized health care arrangement, is an administrative construct under HIPAA that allows information sharing between a hospital and its medical staff, between a health plan and its contracted providers, and between an IPA and its contracted providers. [Posted 03/20/03 ]
"Escaping" HIPAA: A Reality Check
Many physicians have received flyers advising them to "Escape HIPAA" and "Stop HIPAA dead in its tracks." Please be aware that CMA attorneys, and legal experts across the country, agree that physicians are not going to stop HIPAA. The law will go into effect on April 14. It will not be delayed; it will not be stopped. Physicians who deliberately refuse to comply with HIPAA will invite government scrutiny. [Posted 02/06/03 ]
Free "Notice of Privacy Practices" Template Available Online
HIPAA's privacy rule requires that physicians inform each patient of their privacy practices in a written notice. CMA members can get PrivaPlan's "notice of privacy practices" template free at the CMA members-only website. Members can download the template, which is included in ON-CALL document #1603. [Posted 02/06/03 ]
HIPAA Tip: Chart Cabinets
"Does HIPAA require that patient charts be filed in locked cabinets?" This is one of the most commonly asked questions at CMA's Total HIPAA workshops. [Posted 01/30/03 ]
How Sharp Are Your HIPAA Tools?
A number of physicians in California have received a blast fax from a source claiming to be the "Department of HIPAA-Assessment and Compliance" and offering "the complete and revised 2003 HIPAA law and instructions from the Federal Register" for $85. Be advised that the sender of this fax is in no way associated with or endorsed by the federal government. [Posted 01/17/03 ]
HIPAA Tip: Security Rule Delay
Physicians may have heard that the government delayed the publication of HIPAA's final security rule. This delay will not, however, affect a physician's duty to take appropriate security measures by April 14, when the privacy rule goes into effect. [Posted 01/09/03 ]
HIPAA Tip: Using Patient Names
Contrary to rumors, HIPAA's privacy rules do not prohibit the use of patients' names when calling them from the waiting room to see a physician. [Posted 12/12/02 ]
HIPAA Tip: Using Reminder Postcards
HIPAA does not preclude the use of appointment reminder postcards. The postcard, however, should contain no more information than time and date of appointment and the physician's name and contact number. [Posted 12/05/02 ]
HIPAA Tip: Inpatient/Outpatient Privacy Notice Requirements Differ
Physicians who are members of a hospital medical staff that has formed an "Organized Health Care Arrangement" do not have to present each patient they see in the hospital with a privacy notice, as they are covered by the hospital's notice of privacy practices.
CMA Clarifies HIPAA Misconceptions
The Tucson, Arizona-based Association of American Physicians and Surgeons (AAPS) recently wrote its members (some of whom are CMA members) to encourage them to "take the country doctor route" to escape the Health Insurance Portability and Accountability Act (HIPAA) security and transaction confidentiality rules. The letter contained several statements that are misconceptions and warrant clarification.
