About the Book
Comprehensive Strategies
from Microsoft and Washington Publishing Company
“The bottom line is that this solution
is going to help us reach new levels of integration with our customers
and partners, and make us a more agile organization.”
Charles C. Emery, Jr., Ph.D.
Sr. V.P. Information Systems and C.I.O.
Horizon Blue Cross/Blue Shield of New
Jersey
The Health Insurance Portability and Accountability
Act (HIPAA) mandates standardization in electronic healthcare administration.
Washington Publishing Company (WPC)—the main publisher of HIPAA implementation
guides—and Microsoftâ have developed a state-of-the-art solution
to help the healthcare industry make this transition smoothly. Based on
Microsoft BizTalk™ Server 2000 plus technology from WPC, this standards-based
solution for electronic data interchange helps reduce HIPAA compliance
costs by accelerating transactions and eliminating paper-shuffling among
providers, plans, patients, and payers. Find out about:
• THE FUNDAMENTALS: Learn about the origins
of HIPAA, who it affects, its goals and compliance dates, and how it impacts
existing information systems.
• THE BUSINESS CASE: Get the facts about
the long-term benefits of HIPAA and the logistical consequences of using
paper-based claims systems.
• THE SOLUTION: Find out how the technology
in the Microsoft and WPC solution works to help you manage enrollment,
claims, payments, and other transactions.
Related Books
Table of Contents
Preface—Preparation
for Change: HIPAA and the Remaking of Health Care Administration
Introduction
The Solution
x
OnlyConnect
Framework xi
BizTalk
Server 2000 xi
Microsoft
BizTalk Accelerator for HIPAA xii
WPC and
Microsoft Consulting Services xii
Microsoft
Solution Offering (MSO) Support xii
Independent
Software Vendors and Systems Integrators xiii
A Fiscally
Responsible Solution xiii
CHAPTER 1 HIPAA
Minding
the Business of Health Care 1
K2 Trek:
A Look at the Regulation 2
EDI 4
CHAPTER 2 To Implement
HIPAA, or Not to Implement?
Who Must
Comply? 21
Publication
in the Federal Register 22
The Business
Value of EDI 25
The X12
Approach 27
HIPAA-Phobia
29
Pessimistic
Voices 31
The Cost
of Implementation 31
Beyond
Expediency: The Value of Implementing HIPAA for the Entities That Must
33
CHAPTER 3 The HIPAA Solution
Offered by Microsoft and Washington Publishing Company
Core
Technologies 36
Specialized
Technology and Consulting 36
Partners
37
The OnlyConnect
Framework 38
The Solution
in Action 44
CHAPTER 4 Technical Deployment
Overview
Working
in Tandem 56
BizTalk
Server 2000 56
BizTalk
Mapper 57
The OnlyConnect
Gap Analysis Tool 68
OnlyConnect
FirstPass 71
CHAPTER 5 The New Health
Care Economy: A Vision of Fundamental Change
Technology
Empowering Consumers 73
The Health
Care Landscape 74
Provider
Organizations and Physicians 75
Payers
77
Device
Manufacturers 78
Private
Sector Employers, Public Sector Agencies: Funding Health Care 78
Vision
for a New Health Care Economy 79
The New
Healthscape 81
APPENDIX A What Is the
Federal Register?
The Final
HIPAA Rule for Transaction and Code Set Standards 84
Timeline 106
HIPAA Supplemental Information
PART I A HIPAA Glossary
& Acronymary 114
PART II Consolidated HIPAA
Administrative Simplification Final Rule Definitions
45 CFR
160.103 Definitions 140
45 CFR
160.202 Definitions 145
45 CFR
162.103 Definitions 146
45 CFR
164.501 Definitions 147
45 CFR
164.504 Uses and Disclosures: Organizational Requirements 153
PART III Purpose &
Maintenance
Purpose
154
Maintenance
154
INDEX 155 |
