Electronic Transactions… It's Easier Than You Think header
 Summary of the 837 and 835 Electronic Transactions Issue #6
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Introduction

If you have received this e-mail, you have probably received at least one of the preceding five newsletters. Those earlier newsletters have included links to other materials: PowerPoint presentations, a Quick Reference Guide, and useful Internet sites.

This e-mail is the last that you will receive in this series. With this sixth and final newsletter, IHS is pleased to announce that an electronic transactions website is fully operational and a training binder (similar to the HIPAA Privacy Rule Training Binder) is ready to be distributed nationwide.

Implementing electronic transactions is like the children's game of crack the whip. The people at the head of the line exert a huge effort just to get the line moving to begin with. Without them, nothing would happen. As the line overcomes inertia and builds momentum, finally the people at the end of the line go flying by the leaders. At the end, the whole line has succeeded, not just the few who began the effort.

Those involved with electronic transactions have always understood that a team effort is necessary. As a series of IHS veterans put it.

"Well, of course, the management has to support this project - that's critical. If you need help and you can go to management, that's great. You also need people from billing, your Accounts Receivable people on the revenue cycle, your HIMs, . . . then initially also it would be good to have your service unit director, someone at the top, that really kind of understands the process and what it's going to take, and then ultimately probably one of the most key components is your IT staff. . . . Every component of the HIPAA, the HIPAA law, it usually brings in the resources from IT. . . . The most critical part initially is patient registration. Their ability to input information has a great deal of effect on the end result.

The task would have never come to fruition without that type of input from all the different players."

As a recipient of these electronic newsletters you have some involvement in electronic transactions and you know about the changes being implemented throughout IHS in third-party billing and accounts receivable. We hope that you, after reading these newsletters and checking out the resources that have been developed, understand that help is here when you need to work on the 837 Health Claims & Equivalent Encounter Information or the 835 Health Care Payment & Remittance Advice.

You may not need all the information we have gathered to do your job, but at least some of it will apply to you. We have tried to organize the materials so that you can zero in on the parts that will help you most.

As one manager explained it,

"I think one of the most important things that the sites need to remember is that we want to assist them with becoming more efficient and to be able to get the reimbursement in faster, and those are two of the benefits of this project, but the bottom line is we want everyone to become HIPAA compliant, and this is a tool to help sites get to that point. I would fully recommend they use our documents and move forward."

What Do Electronic Transactions Mean For You And Your Coworkers?

Electronic transactions will have benefits for many people once the entire system is implemented and working properly. People who learned electronic transactions the hard way have contributed to the training materials so that others will have an easier time of it.

Here are some of the improvements that they realized:

"With the transaction code sets part of HIPAA, it has really forced organizations to look at that process and standardized it and forced them to put more attention on the staff that do those jobs."
"As painful as it may be getting to the point where you're actually submitting batches that are compliant and they're going to go through and you're going to be paid in a timely manner, when you do anything electronic it's just more efficient. To me that's just good management. I mean, that's just the way it should be."
"The ultimate benefit is that you get more money, faster, with a cleaner process, and that puts money back into the facility to provide the healthcare that the Native Americans need… and that's the real benefit."

How Is IHS Making It Easy For You?

One of the unique characteristics of these training materials is that the information has come from people who are dealing with electronic transactions in the real world. The motivation, the precautions and tips have come from people who mastered the process on their own.

"In sending paper claims it was time consuming. We always ran out of claim forms. We had problems with printing. They were heavy to lift. There were a lot of menial tasks in taking the claim apart. You have to fold it, you have to stuff it, and then you have to mail it off and insurance companies lost your claim, too, and then wait for the turn-around which could vary from 14 to 30 days. Now that we have our transmissions going electronically, we're assured that they got our batches."
"The process has gotten much easier. You get much more familiar with what the errors are when you see them. Also, the software is getting better so that in many cases now the vendor will have the software available that will automatically tell you what the error is and whereit is within the file."
"If we do electronic transactions, it will be a whole lot easier for everybody, so don't be afraid to try; don't be afraid to step into the arena, and if you do take a knock or two, just keep on moving forward, because you'll come out successful."

More help is available than ever before.

A comprehensive training binder of materials is being distributed to 400 people and locations so that as many people as possible will have access to the valuable information that has been developed to help electronic transactions work as smoothly as possible. The binder will include printer-friendly versions of the previous newsletters as well as printed and electronic copies of the PowerPoint presentations and Quick Reference Guides.

The PowerPoint presentations have been revised and enhanced by the inclusion of narration and recorded video interviews with several IHS staff with hands-on experience with electronic transactions. What started as one Quick Reference Guide has expanded and been divided into one section that focuses on the 837 and another that focuses on the 835 transactions because of the number of suggestions that experienced users have shared.

When you have questions, the Area IT Office is the place to start. If the professionals there are unable to answer your questions, contact the ITSC Help Desk. Chances are that if you have questions, others do, too, and the Help Desk is a good switchboard to share the answers.

Where Are We Now?

After all the preliminary materials, IHS is pleased to announce that the "Electronic Transactions . . . It's Easier Than You Think" website is now fully functional. You can click on the link above or enter www.ihs.gov/AdminMngrResources/HIPAA/index.cfm into your browser. Once there, you will probably want to bookmark the site for future reference.

You might think of the website as a really elaborate table of contents for the extensive assortment of materials that have been developed. The website contains useful descriptions of the various resources that are available to you and has hyperlinks that will take you straight to the most up-to-date online information and documents. You can review five previous newsletters and six PowerPoint presentations whenever you need to. Be sure to download the Quick Reference Guides (837 and 835). Many of the resources can be printed or stored on your computer for convenient access to the information that will help you the most when it's most convenient for you.

Check back on the "Electronic Transactions . . . It's Easier Than You Think" website periodically to take advantage of the most current and accurate materials.

As some of the people who were interviewed for their expertise told us,

"This is a challenging program because the third party reimbursement issues and how they relate to software are a high priority for IHS. We have to build support systems to address all the issues. "
"You can copy what we've done and put it into place very quickly. That's going to help you in your collections this year, not later, after you've struggled through trying to do it from scratch. Use what other people have already successfully done and you'll come out way ahead."
"It's been about a two year struggle, but now that we've done all the groundwork, it should be a whole lot easier for everybody because there are examples, there are sets that we have that we can use for everybody."

Of all the insights that helped develop the training materials on electronic transactions, two stand out and cover the most important points.

"With the electronic transmissions, we're able to do the things we need to do, to take care of the people that our mission has us take care of."
"There was a lot of work involved in getting it going initially, but it's gotten a lot easier along the way."

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