Medical Billing Forum

HIPAA => HIPAA => : Sophrosyne October 11, 2011, 06:36:55 PM

: HIPPA 5010 for a small practice
: Sophrosyne October 11, 2011, 06:36:55 PM
So I've been doing research on the much discussed HIPPA 5010, but am still a bit confused about what our office needs to do. We are a very small practice--we have 3 doctors and we currently do not file claims electronically. We do use insurance company websites to check benefits and claims and to request authorizations. We use Therapist Helper, but again, not for electronic claims filing. The only electronic application we use Helper for is credit card processing.
I've heard everyone talking about various levels of testing, but I'm not really sure what is being tested--new HIPPA 5010 compliant versions of software? For applications like electronic claims submission?
I know there are a few other requirements like no PO boxes for providers and 9-digit zipcodes. But so far I have not found any resources on this that are definitive as well as clearly explained.
Any guidance is appreciated!
: Re: HIPPA 5010 for a small practice
: Michele October 13, 2011, 09:50:02 AM
I believe based on what you've described you should not be affected by the HIPPA 5010.  Good job on doing your homework though!
: Re: HIPPA 5010 for a small practice
: PMRNC October 25, 2011, 11:52:27 AM
I know you guys are going to eventually scream at me.. so be it..


IT IS NOT HIPPA.. It's HIPAA!!!
   and BTW.. there's quite a few medical billing companies out there with that misspelling on their website.. JUST SAYING!!

So I've been doing research on the much discussed HIPPA 5010, but am still a bit confused about what our office needs to do. We are a very small practice--we have 3 doctors and we currently do not file claims electronically. We do use insurance company websites to check benefits and claims and to request authorizations. We use Therapist Helper, but again, not for electronic claims filing. The only electronic application we use Helper for is credit card processing.
I've heard everyone talking about various levels of testing, but I'm not really sure what is being tested--new HIPPA 5010 compliant versions of software? For applications like electronic claims submission?
I know there are a few other requirements like no PO boxes for providers and 9-digit zipcodes. But so far I have not found any resources on this that are definitive as well as clearly explained.
Any guidance is appreciated!

While I agree with Michele you probably will not be affected by HIPAA 5010 ELECTRONIC CODE SET/STANDARDS.  Are you a billing company? If so you need to determine your position (most billing companies are considered Business Associates under HIPAA). If you are a provider, you are a COVERED entity and from just our brief description, you are required to be HIPAA compliant.  Don't confuse the new 5010 standards to general HIPAA compliance.
: Re: HIPPA 5010 for a small practice
: Dr. Debra Reble October 25, 2011, 01:48:05 PM
I'm have a small psychology practice and want to be HIPAA complaint. I'm the provider and do all of the billing only by mail. I'm looking at new billing software such as Therapist's Helper to purchase before the 5010 HIPAA deadline. And is that deadline January 1, 2011? Thanks. Dr. Deb
: Re: HIPPA 5010 for a small practice
: PMRNC October 25, 2011, 01:51:33 PM
I'm assuming you will be submitting claims electronically? It really doesn't make sense not to be filing electronic, regardless of how your doing now, it makes no sense NOT to purchase a software that will NOT be HIPAA 5010 ready by 1/1/2012. I've heard from several people that Therapist Helper is telling them that mental health provider's don't have to be ready until 2013 and that is simply false information.  If you are purchasing software I would NOT recommend one that is not HIPAA 5010 ready.