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HIPAA News
Avanta is an NHIC approved vendor for Southern California, Northern California, and Nevada. Our software, which includes all changes necessary for ANSI 4010 compliance, was approved by Medicare a full six months ahead of deadline. All of our clients have received on-site installation and testing of the compliant version.

If you are an Avanta client, each physician in your physician file is required to have a “taxonomy code”. This field is located in the physician file (8, 1, 2 from the Home Screen) on the 3rd screen, field B. If you do not know the taxonomy code for your doctor’s specialty, the Health Care Provider Taxonomy guide can be found at NHIC Medicare.

As always, if you have any questions or concerns, our support staff is standing by ready to answer your call at 1-800-9AVANTA

HIPAA Overview

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HIPAA is the Health Insurance Portability & Accountability Act. The HIPAA Administrative Simplification provision is composed of four parts, each of which has a range of rules and standards. When the these rules and standards become final, they will often have different compliance deadlines. The four parts of the Administrative Simplification provision are:

Electronic Transactions & Code Sets Standards: These standards contain guidelines for simple, uniform electronic health care data submission formats. All health plans will be required to accept this standard electronic data format (called ANSI 4010), and all transmissions must be submitted in this format. The deadline for compliance was originally set for October 16, 2002. However, anticipating possible implementation problems, Congress allowed for a one-year compliance extension to October 16, 2003, if an extension was filed before the original deadline. Avanta is now an NHIC ANSI 837 version 4010 approved vendor.

This standard also requires that health organizations adopt standard code sets to be used in all health transactions. For example, coding systems that describe diseases, injuries, and other health problems, as well as their causes, symptoms and actions taken must conform to these standard code sets.

Privacy Standard: The Privacy Rule specifies who is allowed to access personally identifiable health information. The privacy standard limits the non-consensual use and release of private health information; gives patients new rights to access their medical records and to know who else has accessed them; restricts most disclosure of health information to the minimum needed for the intended purpose; and establishes new criminal and civil sanctions for improper use or disclosure. The deadline to comply was April 15, 2003.

For the average health care provider or health plan, the Privacy Rule requires activities such as: notifying patients about their privacy rights and how their information can be used; adopting and implementing privacy procedures for its practice, hospital, or plan; training employees so that they understand the privacy procedures; designating an individual to be responsible for seeing that the privacy procedures are adopted and followed; and securing patient records containing individually identifiable health information so that they are not readily available to those who do not need them.

Security Standard: The confidentiality of health information is threatened not only by the risk of improper access to stored information, but also by the risk of interception during electronic transmission of the information. The purpose of this final rule is to adopt national standards for safeguards to protect the confidentiality, integrity, and availability of electronic protected health information. Currently, no standard measures exist in the health care industry that address all aspects of the security of electronic health information while it is being stored or during the exchange of that information between entities.

These standards require measures to be taken to secure this information while in the custody of entities covered by HIPAA (covered entities) as well as in transit between covered entities and from covered entities to others. Covered entities, with the exception of small health plans, must comply with the requirements of this final rule by April 21, 2005. Small health plans must comply with the requirements of this final rule by April 21, 2006.

Unique Identifiers: This final rule establishes a standard for a unique employer identifier and requirements concerning its use by health plans, health care clearinghouses, and health care providers. The health plans, health care clearinghouses, and health care providers must use the identifier, among other uses, in connection with certain electronic transactions.

HIPAA Links

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The following are helpful websites that provide additional information on the Health Insurance Portability & Accountability Act (HIPAA). Refer to these websites for important information regarding the implementation of HIPAA and how it will affect your office.

CMS: As of July 1, 2001, the Health Care Financing Administration (HCFA) is now the Center for Medicare & Medicaid Services (CMS). This is their Health Insurance Portability and Accountability Act of 1996 (HIPAA) Page.

WPC: Washington Publishing Company (WPC) specializes in managing and distributing Electronic Data Interchange (EDI) information, primarily in the form of documentation for organizations that develop, maintain, and implement EDI standards.

HHS: The Department of Health and Human Services Administrative Simplification site offers calendars, proposed rules, implementation timetables, news, meeting minutes, full text regulatory documents and FAQs on HIPAA. It also has published the public comments to all proposed HIPAA regulations.

PHS: Sponsored by Phoenix Health Systems, this third party site offers a comprehensive review of HIPAA news, regulations, actions, technologies, etc. Though it is not an official government HIPAA site it offers useful information in a well organized, and detailed format.

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