HIPAAnotes
January 2004

The CMS Guidance, the Provider, the Fiscal Intermediary & the Clearinghouse

Many of us have heard (see the Dec. 29, 2003 news story) that CMS has issued a directive to its contractors and fiscal intermediaries to speed the conversion to standard transactions, as they are most concerned with the potential impact this might have on healthcare providers who utilize a clearinghouse for submitting Medicare claims. The 30-day conversion guidance from CMS was news to many. While CMS issued this additional guidance to their contractors and fiscal intermediaries on December 12, 2003 about this 30-day requirement, it is not an absolute deadline. It is, however, a message to fiscal intermediaries to work with submitters and providers, and identify a plan for conversion within a reasonable time period.

It is very clear that the CMS message to all healthcare organizations is to get moving and make the conversion. Resources have been allocated, work efforts have been underway, and now we need to focus on bringing this initiative to fruition.

Relative to your TCS conversion, the time is NOW to focus on the plan you have in place and the timeline defined for your organization as well as for your trading partners. Do not forget how much work has already been done to implement the standard transactions in your organization and make every effort to avoid losing your momentum and allocated resources.