The HIPAA Connect website is your primary location for all information regarding Health Partners Health Insurance Portability and Accountability Act of 1996 (HIPAA) Administrative Simplification implementation.

Visit this site frequently for the latest HIPAA /EDI Claims updates and resources.

• HIPAA
  
  
• Contingency Plan Announcement
  
  
• HIPAA Transactions and Code Sets FAQs
  
  
• HIPAA Companion Guides
  
  
• National Provider Identifier (NPI)
  
  

• EDI: What is it?
  
  
• Electronic Claims Processing
  
  
• EDI FAQs
  
  
• EDI Fact Sheet
  
  
• EDI Billing Do’s and Don’ts
  
  
• EDI Inquiry Form
  
  
• EDI Process Flowchart
  
  

HIPAA Companion Guides

As per the Health Insurance Portability and Accountability Act of 1996 (HIPAA), all transactions and code sets must be in HIPAA standard format (ASCX12N) by October 16, 2003. To assist you with compliance efforts the following companion guides are available:

• Health Plan Eligibility (270/271)



• Health Claim Status (276/277)



• Health Care Claims (837I & 837P)



• Electronic Remittance Advice (835)

If you are not submitting your own claims, please forward the Guide to your clearinghouse or other entity responsible for your transactions. If you have any questions please call our EDI Support line at 215-991-4290 or 1-888-991-9023.

Back to top

Health Partners Compliance with the National Provider Identifier (NPI)

The Centers for Medicare & Medicaid Services (CMS) announced in January 2004 the adoption of the National Provider Identifier (NPI) as the standard unique health identifier for health care providers to use in filing and processing electronic health care claims and other transactions. All covered health care providers must obtain NPIs. The compliance date of this final rule will be May 23, 2007. However, CMS will provide the health care industry with information relating to the NPI application process and the availability of the NPI application forms, closer to the effective date which is May 23, 2005. The effective date represents the beginning of the implementation period for the NPI mandate and the date on which providers may begin applying for its NPI. Health Partners will adapt its processes, to comply with the NPI requirements by the compliance date.

Back to top