In
1996, the Health Insurance Portability and Accountability Act (HIPAA) became law.
It requires, among other things, that the Department of Health and Human Services
establish national standards for electronic health care transactions and code
sets. Adopting these standards will improve the efficiency and effectiveness of
the nation's health care system by encouraging the widespread use of electronic
data interchange in health care. It also addresses the security and privacy of
health data. The Centers for Medicare & Medicaid Services (CMS) is responsible
for implementing the various unrelated provisions of HIPAA.
Covered Entity: Claim.MD / An Ez2000.net, Inc. Company
Tax ID: 85-0466145
Type of Entity: Value Added Network (VAN)
Authorized Person: Rob Wheeler
Title: President
Address: P.O. Box 1177
City, State, Zip: Pecos, NM, 87552
Telephone: 505-757-6060
Claim.MD is a value
added network service that accepts the transmission of encrypted health care information
to Claim.MD's secure web server where it is authenticated prior to being processed,
reformatted as necessary, and submitted to a clearinghouse via a private network,
dial-up connection or encrypted Internet transmission. Claim.MD has no ownership
rights and is not a user of the data, but is merely a conduit for transmission
of data between users that have a need for the data. Claim.MD does not view privacy-protected
data unless it is necessary to perform its intended task of processing electronic
claims. CMS permits the transmission of protected health data between providers
and other parties who are not Medicare contractors over the Internet if it is
authenticated and encrypted.
Claim.MD further meets compliance standards by including the following text in
its User License Agreement: "All beneficiary-specific information is confidential
and subject to administrative, technical and physical safeguards to ensure the
security and confidentiality of individually identifiable records. This includes
eligibility information, claims, remittance advice, online claims correction and
any other transaction where individually identifiable information is processed
or submitted electronically. Criminal penalties are up to $50,000 and 1 year in
prison for obtaining or disclosing protected health information; up to $100.000
and up to 5 years in prison for obtaining protected health information under false
pretenses; and up to $250,000 and up to 10 years in prison for obtaining or disclosing
protected health information with the intent to sell, transfer, or use it for
commercial advantage, personal gain, or malicious harm."
A copy of this Electronic Health Care Transactions and Code Sets Standards Compliance
Plan is on file with the Centers for Medicare & Medicaid Services, P.O. Box
8040, Baltimore, MD, 21244-8040, 866-282-0659.
NOTE TO PROVIDERS: Claim.MD is not aware of any changes that are necessary
in the data that the provider uploads to Claim.MD. If, in the future, changes
to ANSI format require data that Claim.MD is not currently requiring of providers,
or if any other changes are required by CMS that impact compliance, Claim.MD will
notify providers of these changes and make the necessary changes in the Claim.MD
system to support the new requirements.
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