An updated federal government website is the place to go to lodge a HIPAA-related complaint against a health plan or clearinghouse, or test HIPAA electronic transactions.
The Centers for Medicare & Medicaid Services (CMS) released its Administrative Simplification Enforcement and Testing Tool (ASETT) where physicians — or any individual or organization — can file a complaint against a HIPAA-covered entity for potential noncompliance with the administrative simplification provisions of HIPAA and the Affordable Care Act.
Complaints can fall in the areas of electronic transactions and supporting operating rules (such as electronic funds transfer), medical code sets such as ICD-10, and unique identifiers (i.e., national provider identifier). The ASETT system captures required demographic information about the complainant and the filed-against entity, details of the alleged violation, and any supporting documentation. When filing a complaint, the complainant has the option to remain anonymous to the filed-against entity.
If you believe a HIPAA-covered entity isn’t following a HIPAA standard, you can use the ASETT system to test HIPAA 5010 electronic transactions and operating rules for compliance, syntax, and business rules. In addition, you can validate code values against 60-plus clinical and nonclinical code sets, including ICD-10 diagnostic and inpatient procedure code sets. CMS would then reply with acknowledgment transactions and reports to help identify and resolve errors.
For more HIPAA news and information, visit the TMA website at www.texmed.org/HIPAA, or check out the continuing medical education in the TMA Education Center.
Published Sept. 28, 2016
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Last Updated On
September 28, 2016
Originally Published On
September 28, 2016