The deadline to comply with the Health Insurance Portability and Accountability Act (HIPAA) Transaction and Code Sets Rule was Oct. 16, 2003. If you continue to encounter problems submitting HIPAA-compliant claims, you’re not alone.
As of mid-November 2003, only about 48% of Medicare claims were submitted in the correct format, according to Health Data Management. There also have been anecdotal reports of state Medicaid agencies delaying payments because of claims processing problems. Because of these delays, pediatricians should take some steps to protect their practices.
If you already are sending HIPAA-compliant claims but are encountering payment delays due to payers’ inability to process your claims, you can submit a complaint to the Centers for Medicare & Medicaid Services (CMS) at www.cms.gov/hipaa/hipaa2/enforcement/hipaacomplaint.asp.
The Security Rule became effective on April 21, 2003, and the compliance deadline is April 21, 2005. Pediatricians must take appropriate steps to protect the security of...