HIPAA Electronic Transactions and Code Sets: Questions to Ask Your Vendor

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• Will the current version of my software be able to send a claim/encounter form (the old CMS-1500 form) to all payers in the HIPAA standard 837 format? 
• What new data elements do I need to collect to submit HIPAA-compliant 837 transactions?  
• What transactions have been tested and certified by a third-party (such as Claredi, Edifax, or Foresight) as offering a "HIPAA-ready" solution?    
• Does your HIPAA update require a new version of my software or additional hardware? If so, how much will this cost?  
• Does your HIPAA update require me to use a clearinghouse?  If so, how much will this cost?  (This should include per-transaction fees and an annualized estimate of the total cost.)  
• What is the testing schedule for each transaction (837P, 835, etc.):

- Software installation/internal testing?
- Testing with a clearinghouse (if applicable)?
- Testing with Medicare, Masshealth, BC/BS, HPHC, Tufts, Fallon, etc.?

• What HIPAA training, support and services are you offering?  How much will this cost? 

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