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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
Those involved with electronic transactions have always understood
that a team effort is necessary. As a series of IHS veterans put
"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
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."
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
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
"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
"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."
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
"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.
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
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.
As some of the people who were interviewed for their expertise
"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
"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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