Minnesota HIPAA Collaborative

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• Minnesota HIPAA Collaborative
• Presented by
• Mike Ubl -- BCBS of Minnesota
• Patrice Thaler -- Allina Hospitals Clinics
• Kim Delaney -- HealthPartners

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Minnesota HIPAA Collaborative

• Offering Tools and Free Testing Service
• May 20, 2003
• www.mnhipaacollab.org

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Agenda

• Overview of the Minnesota HIPAA Collaborative
• Origin
• Members
• Goals and Tools
• Free Testing
• What
• Why
• How
• Results

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MN HIPAA Collaborative Origins

• Created out of HIPAA implementation discussions
  among Collaborative members in 2000.
• CIOs from each founding member organization
  created a steering committee to set goals and to
  provide resources for achieving those goals.
• Initial collaborative work effort started with a
  small group of health care companies so that work
  could proceed quickly.

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MN HIPAA Collaborative Membership

• Allina Hospitals and Clinics
• Blue Cross and Blue Shield of Minnesota
• Fairview Health Services
• HealthPartners
• Mayo Foundation
• Medica
• Park Nicollet Health Services
• PreferredOne
• Minnesota Department of Human Services

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MN HIPAA Collaborative Primary Goals

• Helping Minnesota healthcare organizations
  (providers, health plans, clearinghouses) achieve
  timely and cost-effective implementation of the
  HIPAA transactions, code sets, and identifier
  standards
• Promoting HIPAA transaction readiness
• Identifying leading practices
• Recommending solutions through a public web site
• Offering Testing solution

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www.mnhipaacollab.org

• Getting Started
• Transaction Companion Guides
• Transaction Readiness Schedules and Contacts
• Security/Connectivity Matrix
• Testing Tools
• Links to member web sites
• News and Events
• Resource Links
• Register for updates - 500
• Register for free testing
• Hits per month - 1000

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Targeted Transactions Addenda vs. Non-Addenda

• Testing Supports Addenda version Transactions
• 837 - Professional, Institutional and Dental
  Claims
• 835 - Remittance Advice
• 270/271 - Eligibility Inquiry/ Response
• 276/277 - Claims Status Inquiry/ Response
• 278 - Referral/Authorization

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Targeted Transactions Addenda vs. Non-Addenda

• Collaborative supports Addenda version
• Version A1 corrects problems with current 4010
  version
• A1 will be compliant version by October, 2003 due
  date
• Reduce testing multiple versions (4010 then
  4010A1)

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Why Validate?

• Reduce cycle time involved with testing with
  various trading partners by assuring base line
  compliant transactions
• Ensure transaction quality for direct testing
• Minimize duplication of effort

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Why Validate?

• Reduced overall costs due to
• Less rework on level WEDI/SNIP type 1-7 issues
• Faster testing turnaround
• Less resource investment in trading partner
  education
• Fewer test resources being required

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Estimated Benefits

• Average hours saved per transaction on type 1-7
  errors 78-238 hours
• Number of trading partners ranged from 1 to over
  500
• Savings estimated, due to community testing,
  ranges from 80,000 up to over 1,500,000.
• Estimates are based on all transactions between
  providers and payer except the 278.

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The Risks

• Of NOT implementing some form of validation
• Failure to meet HIPAA compliance dates due to
  sheer volume
• Probability of claims dropping to paper is high
• Increase in cash flow problems
• Risks of financial penalty increase

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The Risks

• Of NOT implementing a community based model
• Disproportionate cost to partners who do certify
  or sponsor
• Business-as-usual from a market perspective
• Lost opportunity to realize economies
• Software cost/services sharing
• Standardization/simplification beyond HIPAA

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Why a Community Based Model?

• Lower aggregate cost of shared software and
  services
• Lower education and learning costs
• Wider adoption of standards and consistent
  application
• Simplified change management
• Higher expected provider and payer adoption

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Who Should Test?

• Providers
• Payers
• Clearinghouses
• Billing services
• System vendors

• Service bureaus
• Any entity conducting electronic HIPAA
  transactions should test

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How We Created Free Testing

• Examined three Vendors
• Chose Vendor - EDIFECS
• Created WG to set-up testing site
• Collaborative Members tested site / service

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How We Created Free Testing

• Asked other MN Early Adopters to test site /
  service
• Created Communications Plan
• Announcement to our Trading Partners through
  payer newsletters
• Press Release to general public on 2/27/03.

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What is Free Testing?

• Web-based tool that allows validation of HIPAA
  transactions based on WEDI-SNIP standard types
  1-7 for HIPAA-mandated ANSI X12N version 4010A1
  transactions.
• Guidelines and testing programs specific to some
  collaborative members will also be available.

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How We Implemented

• Public Launch of the Free Testing tool occurred
  February 27, 2003
• Enroll existing trading partners into the program
• Created process to evaluate requests from
  unknown entities

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Statistics 05/12/03

• 1367 Registered Trading Partners
• of organizations testing by Transaction
• 837 Professional -------- 28
• 837 Institutional --------- 18
• 837 Dental ---------------- 2
• 835 Remittance ----------- 7
• 270 Eligibility Inquiry --- 7
• 271 Eligibility Response --4
• 276 Claim Inquiry -------- 1
• 277 Claim Response ------ 1
• 278 Referral --------------- 1

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Questions?