A proposed rule that would establish a unique health plan identifier under HIPAA and would implement several administrative simplification provisions of the Affordable Care Act was announced Monday by the Department of Health and Human Services (HHS).
The possible changes announced by HHS Secretary Kathleen Sebelius would save healthcare providers and health plans up to $4.6 billion over the next 10 years, according to estimates released by the HHS Monday. The estimates were included in a proposed rule that cuts red tape and simplifies administrative processes for doctors, hospitals and health insurance plans.
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Currently, when health plans and third party administrators bill providers, they are identified using a wide range of different identifiers that do not have a standard length or format. As a result, healthcare providers run into a number of time-consuming problems, such as misrouting of transactions, rejection of transactions due to insurance identification errors and difficulty determining patient eligibility.
"The new healthcare law is cutting red tape, making our healthcare system more efficient and saving money," Sebelius said in a written statement. "These important simplifications will mean doctors can spend less time filling out forms and more time seeing patients."
The proposed rule simplifies the administrative process for providers by proposing that health plans have a unique identifier of a standard length and format to facilitate routine use in computer systems. It will allow provider offices to automate and simplify their processes, particularly when processing bills and other transactions.
In addition, the proposed rule delays required ICD-10 compliance by one year – from Oct. 1, 2013 to Oct. 1, 2014.
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Many provider groups have expressed serious concerns about their ability to meet the Oct. 1, 2013, compliance date. The proposed change in the compliance date for ICD-10 would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition to these new code sets.
The proposed rule is the third in a series of administrative simplification rules in the new healthcare law. HHS released the first in July of 2011 and the second in January of 2012, and plans to announce more in the coming months.
Future administrative simplification rules will address the adoption of operating rules for the healthcare electronic funds transfers (EFT) and remittance advice transaction; a standard for claims attachments; and requirements for certification of health plans' compliance with all HIPAA standards and operating rules.
Follow HFN Associate Editor Kelsey Brimmer on Twitter @kbrimmerhfn.
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