AMA: paper claims may swamp payment systems after October 16 - Industry Watch - Brief Article

Healthcare Financial Management, Oct, 2003

The American Medical Association (AMA) warns that physician practices not compliant with HIPAA's electronic transaction standards by the October 16 implementation deadline could face a reimbursement logjam. An AMA survey of physicians, reported in the September 8 American Medical News, shows that only about hall of physician practices have begun testing the HIPAA compliance of their electronic claims processing systems. After October 16, payers-including Medicare-must reject noncompliant electronic claims.

The AMA survey indicates that 13 percent or more of the respondents say they will revert to paper claims if they are not compliant by the implementation date. An increase of as little as 5 percent of paper claims, AMA says, could swamp payers' administrative systems and delay payments. To minimize cash-flow disruptions after October 16, HFMA advises members in physician practices to move toward full electronic implementation quickly and confirm with primary payers whether they have contingency plans for processing legacy system claims after October 16.

To read "Caution Urged for Small Practices Tempted to Take HIPAA Loophole," go to www.ama-assn.org/ sci-pubs/amnews/pick_03/gvl10908.htm.