How can BCBSNC be compliant with HIPAA regulations if the Companion Guide requests only specific values for certain elements within a transaction?
BCBSNC accepts any HIPAA compliant data value within a transaction. However, BCBSNC may only process certain values within a given data set. The BCBSNC Companion Guide transaction chapters specify those data elements that are required for BCBSNC processing. BCBSNC believes this is consistent with the regulations of HIPAA, as illustrated by the following portion of the 837 Institutional Health Care Claim Implementation Guide: 837 Health Care Claim Implementation Guide – Section 1.3: “Payers are required by law to have the capability to send/receive all HIPAA transactions. However, that does not mean that the payer is required to bring that data into their adjudication system. The payer, acting in accordance with policy and contractual agreements, can ignore data within the 837 data set. In light of this, it is permissible for trading partners to specify a subset of an implementation guide as data they are able to ‘process’ or act upon most efficiently. It behooves trading partners to be
BCBSNC accepts any HIPAA compliant data value within a transaction. However, BCBSNC may only process certain values within a given data set. The BCBSNC Companion Guide transaction chapters specify those data elements that are required for BCBSNC processing. BCBSNC believes this is consistent with the regulations of HIPAA, as illustrated by the following portion of the 837 Institutional Health Care Claim Implementation Guide: 837 Health Care Claim Implementation Guide – Section 1.3: “Payers are required by law to have the capability to send/receive all HIPAA transactions. However, that does not mean that the payer is required to bring that data into their adjudication system. The payer, acting in accordance with policy and contractual agreements, can ignore data within the 837 data set. In light of this, it is permissible for trading partners to specify a subset of an implementation guide as data they are able to ‘process’ or act upon most efficiently.
Related Questions
- How can BCBSNC be compliant with HIPAA regulations if the Companion Guide requests only specific values for certain elements within a transaction?
- Does BCBSNC have a Companion Guide to assist trading partners in the transmission of HIPAA compliant EDI transactions with BCBSNC?
- Is the current edition of the companion guide HIPAA compliant?
