Wisconsin Medicaid HIPAA
Questions and Answers
Q: What are DHCF state health care programs doing to prepare
for HIPAA?
A: The DHCF held HIPAA information sharing sessions in
2001. In 2002, the DHCF will hold additional training sessions for
providers, HMOs, clearinghouses, vendors, etc. on the effects of the
federal HIPAA regulations as they relate to the state programs. Refer to
DHCF publications and the HIPAA Web site for dates and locations of the
training sessions. The DHCF will also issue Medicaid
publications
to keep affected entities informed of all policy changes made as a
result of HIPAA requirements, including a new insert to the Wisconsin
Medicaid and BadgerCare Update called HIPAA inSight.
Q: Will paper claims be affected by HIPAA?
A: Yes. It is very important to understand that although
HIPAA legislation targets standardization of electronic transactions,
HIPAA will also affect many aspects of paper billing, such as changes to
coding structures and required data elements. However, HIPAA does not
require providers to submit their claims electronically.
Q: What should providers be doing to prepare for HIPAA?
A: Providers are responsible for ensuring their organization's
timely compliance with HIPAA. The DHFS recommends that you:
- Begin to familiarize yourself with the proposed HIPAA regulations
and implementation guides, which can be found on the Internet.
- Evaluate your organization's current business processes.
- Identify gaps by comparing the information you currently support
electronically with the information that is required in the HIPAA
transactions.
- Determine where and how best to fill these gaps so that your
computer system will be able to support HIPAA transactions.
If you use a software vendor, billing service, or clearinghouse, we
recommend that you contact them regarding potential upgrades to
their products.
Click here to return to general HIPAA
questions and answers.
Last updated: October 20, 2004
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