The American Hospital Association wants the CMS to help ensure that information shared between health plans and providers about claims transactions doesn't fall into an “electronic black hole.”
AHA petitions CMS on e-transactions
In a letter to the CMS this week (PDF), the AHA urged the agency to include in an upcoming final rule on administrative simplification a so-called acknowledgments rule, whereby health plans and providers would be notified of receipt of an electronic transaction.
The feedback from the AHA was in response to the CMS' interim final rule, released July 8, regarding federal adoption of operating rules for health-plan eligibility and healthcare claim status transactions. Although the AHA supports the Phase I and Phase II operating rules from the Council for Affordable Quality Healthcare's Committee on Operating Rules for Information Exchange, or CAQH CORE, the association said it was disappointed that the acknowledgments rule was not included.
“The operating rule for acknowledgments is essential to maximizing the benefits associated with the use of the other operating rules and is the only portion of the Phase I and II operating rules package that was not adopted,” AHA Executive Vice President Rick Pollack wrote in the letter to CMS Administrator Dr. Donald Berwick. “The acknowledgments rule maximizes the reduction in administrative costs and routines,” he continued. “Both providers and health plans view acknowledgments as essential to improving the end-to-end processing of transactions because they let both parties know that electronic transactions from the other have been received and accepted, thereby avoiding the electronic ‘black hole' into which transactions can fall.”
The AHA also recommended that the CMS make CAQH CORE the single author of operating rules for all medical transactions and issue its final regulation before the rule's planned release on Jan. 1, 2012.
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