The Centers for Medicare & Medicaid Services (CMS) announced August 4, 2005 that CMS will not process incoming non-HIPAA-compliant electronic Medicare claims submitted for payment beginning October 1, 2005. To read more information on this subject, please view the Medlearn Matters article, MM3956, made available by CMS on www.cms.hhs.gov/medlearn/matters.

Prior to October 1, 2005, claims in a non-compliant electronic format will continue to be paid. This process changes as of October 1, 2005, when claims that do not meet standards required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be returned to the filer for re-submission as compliant claims. Non-compliant claims will not be processed. If you have not transitioned your electronic Medicare claim submissions to the HIPAA compliant format, now is the time! As instructed by CMS, Medicare payers across the US will be mailing a letter to all non-HIPAA compliant Medicare providers that have not submitted at least one electronic claim in a HIPAA compliant format to inform them of the HIPAA contingency plan termination. These Medicare payers may or may not, enclose the appropriate paperwork for your office to complete and mail back to the Medicare payer, to get set up for the HIPAA compliant format. It is very important to become HIPAA compliant as soon as possible to avoid interruption in claim payment. To ensure your office does not have payment interruptions, mail the paperwork back as instructed by your Medicare carrier as soon as possible as provider testing for the HIPAA compliant format will be on a first-come first-serve basis.

If you have any questions concerning these important HIPAA issues please contact your local Medicare carrier. You can also contact the Healthcare Practice Management and Consulting staff of BCS, Incorporated to assist with any questions you may have. 888-278-4124.