decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2002 / B-02-038
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Article Overview
This article summarizes a CMS Program Memorandum addressing HIPAA testing and certification timelines for Medicare carriers and DMERCs. It explains the broad categories of transaction testing, certification scheduling, Medicare Part B and DMERC business requirements, reporting expectations, and implementation timing. It is relevant to Medicare EDI, compliance, and systems teams working with claim, remittance, coordination of benefits, claim status, and eligibility transactions.
Why This Topic Matters
It helps organizations understand the scope of CMS certification expectations and the timing of required testing activities under the memorandum.
Article Sections
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Program Memorandum and subject overview
Introduces the memorandum, issuing organizations, and the general topic of updated HIPAA testing and certification guidance.
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Background
Summarizes the earlier testing and certification expectations referenced by the memorandum and the transaction categories involved.
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Revised Requirements
Outlines the updated certification framework, the transaction types covered, the general sequencing of testing, and related operational considerations.
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Medicare Part B Business Requirements
Describes the attached materials that support certification for Part B and DMERC claims and identifies the broad categories of requirements they cover.
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Reporting Requirements
Covers the reporting cadence for EDI trading partner testing and the distribution of those reports.
What You Will Learn
- The scope of CMS HIPAA testing and certification guidance for Medicare contractors.
- Which broad transaction categories are covered by the memorandum.
- How the memorandum frames Medicare Part B and DMERC business requirement documentation.
- What reporting and implementation timing the memorandum addresses.
Who Should Read This
- Medicare carriers
- DMERCs
- EDI trading partner testing staff
- HIPAA compliance teams
- Medicare systems and operations personnel
Codes Discussed
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