May a health plan require a provider to use a health care clearinghouse to conduct a HIPPA-covered transaction, or must the health plan acquire the ability to conduct the transaction directly with those providers capable of conducting direct transactions?

Question

Roger Berger · Accepted Answer

A health plan may conduct its covered transactions through a clearinghouse, and may require a provider to conduct covered transactions with it through a clearinghouse. But the incremental cost of doing so must be borne by the health plan. It is a cost-benefit decision on the part of the health plan whether to acquire the ability to conduct HIPPA transactions directly with other entities, or to require use of a clearinghouse.

Roger Berger · Answer

A health plan may not conduct it's covered transactions through a clearinghouse

Roger Berger · Answer

A health plan may after taking specific permission from HIPPA authorities conduct its covered transactions through a clearinghouse

Roger Berger · Answer

is not as per HIPPA allowed to require provider to conduct covered transactions with it through a clearinghouse

Question list

List of questions

Question 1

(0)

Question 2

(0)

Question 3

(0)

Question 4

(0)

Question 5

(0)

Question 6

(0)

Question 7

(0)

Question 8

(0)

Question 9

(0)

Question 10

(0)

Related questions

Question 23 - HCISPP discussion

Suggested answer: A

0 comments