Article: HIPAA could impact state 'prompt pay' laws: 'clean claim' redefined?(Practice Trends)

WASHINGTON -- State "prompt pay" laws could be affected by the "transaction and code set" provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that went into effect last month, Ann Leopold Kaplan said at a forum sponsored by the American Health Lawyers Association

Prompt pay laws require insurers to promptly pay providers who have submitted "clean claims," said Ms. Kaplan, a lawyer who specializes in health care policy. The question is, "Does a [HIPAA] compliant transaction equal a clean claim?"

HIPAA sets out specific instructions about how a claim must be formatted and what fields it must contain in order to be accepted ...

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