Category
of Questions |
For
Billing System Vendors, Billing Service Vendors, and
Clearinghouse Vendors re: Claims related Transactions |
| Extensions |
How
are you relating to us re: HIPAA extensions? Are you encouraging
and/or facilitating our application for an extension?
How are you communicating your HIPAA compliance to us?
NOTE: see: http://www.cms.hhs.gov/hippa2/ascaform.asp |
Claims
pathways
(pre & post HIPAA)
|
For
each payer indicate:
• The current claim pathway (i.e., EMC/Direct, clearinghouse,
paper)
• The post HIPAA claim pathway |
For
each claim pathway:
Software Requirements |
For
Billing Software Vendors Only:
Will HIPAA compliance require us to upgrade our software?
Is the new release available? How many clients have been
upgraded? If the new release is not available, when will
it be? Do the answers to these questions vary by provider
type or specialty? |
For
each claim pathway:
Testing Plan |
How
will you test HIPAA compliance with payers? If available,
indicate your testing schedule. What are our responsibilities?
Do the answers to these questions vary by provider type
or specialty?
For
Clearinghouses only:
How will you assure that the billing system vendors
you interface with are HIPAA compliant?
|
For
each claim pathway:
Certification |
Have
you/will you obtain 3rd party certification of HIPAA compliance?
How will we be notified regarding your certification status?
Does the answer to this question vary by provider type
or specialty? |
For
each claim pathway:
Current Status
|
How
would you characterize your overall HIPAA compliance status:
in remediation? in testing? in implementation? Other?
Do the answers to these questions vary by provider type
or specialty? |
| For
all claims |
Are
there any changes in the way we capture and submit billing
data? Will I need to supply any additional data that I
do not provide today? Are there new codes that we will
be required to use? What can we do to prepare for HIPAA
while you (the vendor) make necessary changes in software,
etc.? |
| For
paper claims |
Why
are these not being sent electronically? |
| Contingency
plans |
In
the event your implementation plan for claims does not
work, do you have a contingency plan? |
| Contact
Information |
Who
should we contact re: HIPAA compliance for claims related
transactions? |
Category
of Questions |
For
Billing System Vendors, Billing Service Vendors, and
Clearinghouse Vendors re: Non-claims related Transactions |
| Extensions |
How
are you relating to us re: HIPAA extensions? Are you encouraging
and/or facilitating our application for an extension?
How are you communicating your HIPAA compliance to us?
NOTE: see: http://www.cms.hhs.gov/hippa2/ascaform.asp |
| Transactions
supported |
What
non-claims transactions do you support? Do you plan on
being HIPAA compliant for each transaction type? |
For
each transaction:
Timing |
When
will you be HIPAA compliant for each non-claims transaction
type? Do you need any information from Mass. Payers? |
| For
each transaction: Software Requirements |
Will
HIPAA compliance require us to upgrade our software?
Is the new release available? How many clients have
been upgraded? If the new release is not available,
when will it be? Do the answers to these questions vary
by provider type or specialty? |
| For
each transaction: Testing Plan |
How
will you test HIPAA compliance with payers? If available,
indicate your testing schedule. Do the answers to these
questions vary by provider type or specialty? |
For
each transaction: Certification
|
Have
you/will you obtain 3rd party certification of HIPAA compliance?
How will we be notified regarding certification status?
Does the answer to this question vary by provider type
or specialty? |
| For
each transaction: Current Status |
How
would you characterize your overall HIPAA compliance status:
in remediation? In testing? In implementation? Other?
Do the answers to these questions vary by provided type
or specialty? |
| For
each transaction: Impact of Processes |
Will
we be able to do the same non-claims transactions to the
same payers, but in a HIPAA compliant manner? Are there
any changes required in our office business processes
to do the transactions? Is there any additional data required
that I do not provide today? What can we do to prepare
for HIPAA while you (the vendor) make necessary changes
in software, etc.? |
| Contingency
plans |
In
the event your implementation plan for non-claims transactions
does not work, do you have a contingency plan? |
| Contact
Information |
Who
should we contact re: HIPAA compliance for non-claims
related transactions? |
