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Electronic Claims Submission

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Contents

MU Requirements

Meaningful Use Measures:

At least 80% of all claims filed electronically.


Certification Criteria for EHR:

Enable a user to electronically submit claims to public or private payers in accordance with the applicable standards specified in Table 2A row 4: Applicable HIPAA transaction standards required by law.


COMPONENT R: ELECTRONIC CLAIMS SUBMISSION

  • The technology shall have the ability to submit claims electronically to public and private payers.
  • HIPAA X12 4010A1, and NCPDP Script 5.1, and CAQH CORE Phase I and Phase II - or -

Allowable alternatives for 2011 and 2012:

  • HIPAA X12 5010 and NCPDP Script 10.x per
  • HIPAA rules, and CAQH CORE Phase I and Phase II

The technology shall have the ability to report % claims submitted electronically to all MU.P1.G1 payers.

Proposed Solution

  • Current Claims Billing Modules meet the requirement for submission
  • One of the typical reports needs to have percentage by carrier added, 1-2 hrs max hrs estimated

Effected Code, Tables, etc

Owner and Status

Tony, MI2, In progress

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