Medicare Compliance & Reimbursement
Get the Facts on the 6 Phases of HIPAA Administrative Simplification Complaint Process
Tip: Take advantage of CMS’ compliance resources. Whether you want to lodge a complaint against another provider or you’re the covered entity (CE) under review, there are a series of steps you must go through as part of the feds’ complaint management system. Reminder: The Centers for Medicare & Medicaid Services (CMS) enforces the HIPAA Administrative Simplification Rule requirements for the Department of Health and Human Services (HHS). Part of the agency’s enforcement duties concern reviewing CE’s compliance with transactions, standards, codes, and operations. If you suspect a CE isn’t being compliant with these requirements, you can file a complaint, CMS says in a May 11 alert. “Filing a complaint begins a multi-step process during which HHS conducts an investigation of the allegations. HHS then works with the complaint entities to resolve any issues,” the agency notes. The six-part process starts after CMS receives the complaint through an “Intake” point. You can review the other five steps, which conclude with “Closure,” at www.cms.gov/Regulations-and-Guidance/Administrative- Simplification/Enforcements/Downloads/ ASComplaintProcessIG20190702.pdf.
Medicare Compliance & Reimbursement
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Get the Facts on the 6 Phases of HIPAA Administrative Simplification Complaint Process
Tip: Take advantage of CMS’ compliance resources. Whether you want to lodge a complaint against [...]
