Frequently Asked Questions and Helpful HIPAA Tips
Will an AHCCCS Trading Partner need to certify if using a
commercial product that has been certified by Claredi as producing HIPAA
compliant transactions?
If a Trading Partner has not modified the certified commercial product
then document the certification of the software being used and it will
meet AHCCCS certification requirements. If the commercial product has been
customized then the Trading Partner will need to re-certify HIPAA
compliance.
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How will AHCCCS support eligibility inquiry/response
transactions?
Beginning in October 2003 AHCCCS will support the 270/271 HIPAA
Transaction Set. Support from AHCCCS will be at no charge to the
requestor. There will be two modes of support: real Time via the Web and
a batch facility via the AHCCCS FTP server for overnight response. In
addition, AHCCCS will have contracts, effective October 2003, with three
vendors to also supply eligibility information to AHCCCS Providers
(EVS/MEVS). These services usually have a charge to the Provider
associated with the service.
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What are the Business Associate contract amendment
deadlines?
In reference to 45 CFR 164.532(e), for contracts with business
associates entered into or renewed after October 15, 2002, the contracts
should have been executed or amended to include the required BA terms. For
contracts with BA's that existed prior to October 15, 2002 and have not
been renewed since that date, a covered entity has until April 14, 2004,
to amend the agreements to include the required BA language.
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What if a Trading Partner has not completed HIPAA
transaction testing with AHCCCS before the October 16, 2003 deadline?
AHCCCS has surveyed Trading Partners to ascertain their testing
readiness schedule by transaction in order to adjust our testing schedules
to be as accommodating as possible. If testing has not been completed for
a specific transaction, the Trading Partner will not be permitted to go
into production with that transaction until testing is completed.
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How will the files that are currently electronically
traded with AHCCCS be changed by the implementation of HIPPA transactions?
For the planned AHCCCS HIPAA implementation:
- The HIPAA U277 - Unsolicited Claim Status replaces the Adjudicated
Encounter File
- The HIPAA 837 and NCPDP Transactions replaces the New Day Encounter
Files
- The HIPAA 834 transaction replaces the Daily and Monthly Roster
Files, the Prior Plan file and the For Your Information (FYI) file.
- The HIPAA 820 transaction will replace the financial information on
the Daily and Monthly Roster Files.
- The current plan is that the remaining files and reports will be
exchanged.
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What is the difference between Companion Documents and Transaction
Work Papers?
The Transaction Work Papers have been developed by the AHCCCS HIPAA
Project Work Groups and are posted as DRAFT reference documents on the
AHCCCS web site under the Documents section. The content of all DRAFT
Transaction Work Papers is subject to change.
Companion Documents include transaction descriptive and technical
information in addition to the specific transaction agreements that are
based on the final version of the specific Transaction Work Paper. AHCCCS
Companion Document availability will be announced at Monthly Consortium
Meetings and posted in Draft and Final form on the AHCCCS HIPAA web site
under the Documents section.
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Will the Case Management electronic submissions to the
Arizona Long Term Care System (ALTCS) be excluded from HIPAA compliance
requirements?
The ALTCS Case Management submissions do not need to be HIPAA-compliant. These transactions are still listed in the AHCCCS
Technical Interface guidelines as being status quo.
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