HIPAA

The Health Insurance Portability and Accountability Act (HIPAA)

HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996. The Centers for Medicare & Medicaid Services (CMS) is responsible for implementing various unrelated provisions of HIPAA, therefore HIPAA may mean different things to different people. Here are PolyCommerce's business activities with regard to HIPAA.

HIPAA Administrative Simplification

The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) require the Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addresses the security and privacy of health data. Adopting these standards will improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in health care.

HIPPA Benefits

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) promises to revolutionize Health Information Management. Health Plans, Health Care Clearinghouses, and any Health Care Provider who transmits Health Information in electronic form in connection with a standardized transaction should have already begun taking steps to adhere to HIPAA's strict new standards.

Mandated enterprise-wide compliance initiatives will require health care entities, over the next two years, to reengineer all processes surrounding the capture, storage and transmission of health information. In spite of the immense scope and initial resource requirements of this initiative, the benefits will be very significant! After these standards have been put in place, a Healthcare Provider will be able to submit data for claims and other standardized transactions using an industry standardized EDI template. All Health Plans are required to accept and process standardized transactions without imposing delays because of format or content. Resulting in:

		Decreased administrative burden - Less time and cost to complete many clinical, billing, and other financial work flow processes.
		More efficient, cost-effective processing
		Standardizes the flow of electronic health information. Facilitates improved relationships between health care partners.
		Speedier flow of information between entities
		Results in better patient care and decreased reimbursement time. Provides a method to conduct streamlined, accurate B2B transaction processing.
		Stricter Security Measures - to protect the physical accessibility of patient health information.
		Greater Privacy protection - to safeguard the disclosure of confidential patient health information.

Standardizing transactions will make electronic data interchange the preferred method of doing business over current paper processing methods.

Ultimately, HIPAA is poised to create a dramatic improvement in the efficiency and effectiveness of the health care system.

HIPAA Compliance Planning

This Implementation Plan is appropriate for submission to the Federal Government to certify your organization's HIPAA Compliance for 2002.

The project phases included in the Compliance Planning Solution
	Strategic Project Planning
	HIPAA Team Assembly, Training & Direction
	Initial HIPAA Readiness Assessment
	Gap Analysis to discover areas of noncompliance
	Risk Analysis to compare and prioritize options

HIPAA Compliance Implementation Solutions

The project phases included in the Implementation Solution
	Business process and automated systems remediation
	Documentation and Policy & Procedure Development
	Testing & Implementation of all directives
	Post-Implementation Support
	Enterprise Wide HIPAA Education