1. If I understand this correctly, I need to file electronically to ALL insurance companies by Wednesday, 10/16/02. #1, there are times that I need to send notes, how do I do this electronically? #2, what if the insurance company doesn't accept electronic claims? #3, I am assuming that secondary insurance submission remains as a paper submission because the primary EOB has to be attached?

(a) You are required to have your billing software compliant with the new ANSI standards in 7 days. If you do not, your client, the provider, must submit an electronic extension by next Tuesday. (b) Under the Administration Simplification portion of HIPAA, if the carrier accepts claims electronically, then they must be able to accept everything else electronically. This means notes too Toto! (c) The insurance company that is small and doesn't accept claims electronically has until October 16, 2003 to get ready to start accepting claims electronically. With EOBs, see (b).


2. I do understand that I as a billing service do not have to file for a HIPAA extension but my clients need to if they haven't put together a compliance plan. Is this correct? So, if my client has a compliance plan in place they do not need to worry about an extension request?

A compliance plan is something suggested by the OIG, therefore voluntary. HIPAA is mandated! You are required to do it! A compliance plan is something we should all have that lists the things we do, how we do them, what to look for that may get us into trouble, and what to do if we see something wrong happening. HIPAA is a whole different ballgame. My recommendation is that your clients rush down to the CMS website and file their extension ASAP. Then they have about 4 months of breathing room to work with. To know more, sign up for the MAB HIPAA seminar in December.



3. My other problem that I have is that one of my clients doesn't feel that they need to even worry about HIPAA compliance - what do I need to tell them?

Can they afford a $100,000 fine and 5 years in the grey bar hotel! Can they afford the loss of revenue because they failed to file for an extension and can't get paid for their claims! Can they face the loss of licensure and exclusions from governmental programs? Do they wish to be sued for a simple privacy violation. HIPAA is law! It is here and now! The first part takes affect 7 days from today!


4. A billing service needs to have a compliance plan in place. Is this correct? If correct, do I just keep the plan in my office or do I need to send it somewhere?


Correct! Your compliance plan is yours. Your providers need one as well. You keep it in your office. You update it, you read it, you follow it!