November 1, 2004

Note: The survey referenced in the following article ended midnight, December 17, 2004.

The Department of Health Care Services (DHS) is asking providers to complete a HIPAA Linking Paper Attachments Survey and is looking for providers interested in a future pilot testing program. The survey is intended to gauge the usability of a new process that will link paper attachments to 837 v.4010A1 electronic claim submissions. The pilot program will give providers the opportunity to preview the new process.

The linking will be achieved through a unique number called an Attachment Control Number (ACN), which submitters will need to input on their 837 v.4010A1 electronic claim submission in a specified field. The ACN will electronically associate all paper attachments with the Claim Control Number (CCN). The ACN will be preprinted on an Attachment Control Form (ACF) that providers will need to mail to Medi-Cal along with the necessary paper attachments. Medi-Cal will then link the paper attachments to the electronic claim by the ACN. This process is similar to one providers have been using for years, through which an approved Treatment Authorization Request (TAR) is linked to an electronic claim by a number entered on the claim.

Providers interested in pilot testing can provide contact information at the end of the survey. Providers not interested in completing the survey but who are interested in participating in the pilot program should call the Telephone Service Center (TSC) at 1-800-541-5555.

For more information, visit the HIPAA Linking Paper Attachments Questions and Answers page.

Background
HIPAA mandates that all electronic health care claims or encounters (with the exception of pharmacy) meet the ANSI ASC X12N 837 standard transactions for Electronic Data Interchange (EDI) as specified in the Final Rule for Transactions and Codes Sets. HIPAA also mandates that an electronic claim cannot be rejected because it requires an attachment. Therefore, it is necessary to modify the California Medicaid Management Information System (CA-MMIS) to process paper attachments submitted in conjunction with 837 v.4010A1 electronic claims. Note that providers will still be able to submit paper claims with attachments.