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Consulting Services Training Services		HIPAA Compliance As part of the Healthcare Insurance Portability and Accountability Act (HIPAA), the Department of Health and Human Services issued standards for electronic data transactions to be used in the administration of health care data and claims. Beginning no later than October 2003, provider organizations are required to comply with the HIPAA transaction and code set standards and to submit claims electronically. The HIPAA transaction and code set standards are expected to provide operational efficiencies and long-term cost savings, as software will no longer need to adapt to multiple formats required by various providers and plans.   HIPAA data standards are in the form of transaction sets and reference tables. Many companies believe that they are compliant with the HIPAA data standards because the third-party software applications state they are compliant. Metaview360 looks under the covers to ensure that all of your transactions are compliant to avoid civil and criminal penalties.   Beyond HIPAA Compliance HIPAA data compliance is only the first step in data quality. HIPAA regulations focus on the types, lengths, and order of data elements in a transaction. HIPAA compliance does not ensure that the data in the transaction is correct or understandable. Data quality processes ensure that the data in the transaction accurately reflects the actual claim information.   Metaview360 goes beyond simple HIPAA compliance to ensure that health plan providers, physician practices, hospitals, and other health service providers are paid as quickly as possible for the specific services that they have provided to or contracted for patients. Metaview360 can uncover data quality issues that may have existed for years - and correct them to ensure quick, accurate, and complete reimbursement for services.   Quality Analysis Metaview360 starts by inventorying your key data sources and applications. Then, Metaview360 understands the business rules that determine the quality and accuracy of your data. Using industry-leading data quality tools, such as MetaPure™ from Metagenix, Metaview360 builds in the business rules to analyze your current data. The results of the analysis are used to create recommendations for: data cleansing sizing the cost of poor data quality business process improvement ongoing data quality monitoring data quality education and training Metaview360 can automate the checking of the complex business rules that are set by insurance plans. Metaview360 can help you identify data problems before they turn into business problems, such as: Mismatches between personal coverage data and claim data Compliance with reimbursement rules Tracking claims per procedure per patient By uncovering data problems early, Metaview360 helps you: Improve plan participant satisfaction Maximize claim payment Reduce re-submission of claims Free Consultation Call Metaview360 today for a free, onsite consultation with one of their data quality experts. Learn ways data quality may be affecting your bottom line. Contact Barbara Nichols at 978.790.3457 or freeconsultation@Metaview360.com to arrange your free consultation.
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