tci Medicare Compliance & Reimbursement - 2023 Issue Q2

Industry Notes: Get the Facts on the 6 Phases of HIPAA Administrative Simplification Complaint Process

Tip: Take advantage of CMS’ compliance resources. Whether you want to lodge a complaint against another provider or you’re the covered entity (CE) under review, there are a series of steps you must go through as part of the feds’ complaint management system. Reminder: The Centers for Medicare & Medicaid Services (CMS) enforces the HIPAA Administrative Simplification Rule requirements for the Department of Health and Human Services (HHS). Part of the agency’s enforcement duties concern reviewing CE’s compliance with transactions, standards, codes, and operations. If you suspect a CE isn’t being compliant with these requirements...

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