| HIPAA testing and contingency services launched Physmark Inc., has launched its new ‘HIPAA Testing and Contingency Services’ to assist healthcare entities in meeting federal HIPAA (Health Insurance Portability and Accountability Act) deadlines. Physicians, hospitals, laboratories, employers, insurers, HMOs, Medicaid systems and state health departments have either acquired new software or modified their existing software to meet the new HIPAA electronic communication standards. The Administrative Simplification Compliance Act (the law that allowed the HIPAA enforcement date to be extended by a year) requires that testing begin well in advance in order to minimise business disruptions arising from software-related problems when going live in October 2003. Physmark's HIPAA Testing and Contingency Services
offer three features: There are many instances where a payer (i.e., a healthplan, insurer, HMO or even a state Medicaid system) has not completed their HIPAA work but key trading partners are ready to test. Waiting until completion can mean that testing will take place after HIPAA's mandated deadline and cause delays in payments to providers. As a result, payment for expensive but necessary treatments can be delayed. Physmark's HIPAA Testing and Contingency Services lets payers avoid delays and the consequent denial of treatment to patients. Depending upon a provider's specialty, HIPAA transactions can be very different in both structure and content. A key ingredient to testing is to simulate all possible business scenarios arising from the various provider specialties. In meeting this challenge Physmark has created tens of thousands of representative transactions in order to check every prescription in the HIPAA guidelines. Physmark accepts this complex data and verifies the accuracy of its construction. Equally, Physmark provides volumes of test data to help a large payer or Medicaid organisation test their system. During and even after the testing phase, rejections are bound to occur. Clearly explaining the cause of the problem so that trading partners can make the necessary corrections is absolutely critical. Physmark's software, called HIPAA Appliance, has over 20,000 error codes with descriptive explanations and contextual references to the implementation guide, making it extremely easy for a trading partner to correct and resubmit their claims in the right format. For those organisations that fear they will miss the HIPAA deadline, Physmark, in association with SIS Technologies of Houston, provides a clearinghouse service as an interim backup. Physmark's staff provides assistance in rapidly creating the necessary interfaces and SIS Technologies has a HIPAA-compliant clearinghouse powered by Sun Microsystems hardware and Physmark's HIPAA Appliance ready for immediate use. Like other clearinghouses, HIPAA Appliance(TM) has a built-in translator but merely translating and making available thousands of fields in a HIPAA claim transaction is ineffective when a legacy system can accept only 75 fields. Rather than modifying the legacy system to accept these data elements (as other clearinghouses require), HIPAA Appliance stores these extra fields in its data repository, making them available when necessary. Through its data repository, HIPAA Appliance also provides the options of direct web access and data mining, again without undertaking a costly modification of an organisation's in-place legacy system.
•Date:
1st September 2003 • Region: N.America •Type:
Article •Topic: Sector
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