Health Insurance Portability and Accountability Act

HIPAA was signed into law on August 21st, 1996

This law impacts all areas of the health care industry

Listed below are some of the major components

HIPAA allows a health care provider and/or billing service to use a clearinghouse to convert non-standard transactions (claims) to standard transactions. ABS will continue to accept non-standard transactions from healthcare providers and will be forwarding all claims to the appropriate health plans in a standard transaction format. This is done through the clearinghouse ABS uses. As each health plan becomes “ready” to accept the new format, ABS will work with the clearinghouse to coordinate a start date with them.

  • Standards for transactions and data elements that are exchanged electronically for such transactions   Compliance was required by October 1st, 2002 unless a one-year extension was granted. Small health plans had until October 16th, 2003. These standards include ASC X12N 837 ver 4010 for Health care claims and code sets ICD-9-CM, CPT-4, CPT-5, HCPCS, CDT-2 (dental) and NDC (drug codes).

  • ABS is currently “outbound-compliant” with the new transaction standards and will continue to be approved as more health plans switch to electronic billing    Many health plans have filed for a one-year extension. Medicare, Medicaid and BC/BS National Association have issued contingency plans that allow for the transmission of non-compliant claims after October 15th, 2003 to ensure the payment f claims. Hopefully, the use of a contingency plan will reduce the pressure of the deadline.

  • Privacy Regulations to protect the privacy and confidentiality of health information   Compliance was required by April 14th, 2003. ABS has and will always protect the privacy of an individual's health information. ABS will continue to review the privacy law and make the appropriate changes, as required, to be in compliance with HIPAA privacy regulations.

  • Security standards to ensure the privacy and confidentiality of health information when it is electronically stored, maintained or transmitted   This standard also creates a separate standard for electronic signatures. The security standard regulations have not been officially published and are still in draft form. Compliance will not be required until 24 months after its adoption and publication

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