July 27, 2005

Note:The survey referenced in the following article ended August 31, 2005.

The Department of Health Care Services (DHS) is asking Vision Care providers to complete a Vision Care Survey.

Background
DHS is continuing to use a phased approach to implement HIPAA requirements. HIPAA mandates that all electronic health care claims or encounters (except pharmacy) meet the ASC X12N 837 v.4010A1 standard transactions requirements for Electronic Data Interchange (EDI) as specified in the Final Rule for Transactions and Codes Sets. Therefore, vision claims submitted electronically must comply with the ASC X12N 837 v.4010A1 format.

HIPAA-mandated changes include the following:

• Conversion of the Payment Request for Vision Care and Appliances (45-1) to the CMS 1500 (currentlyHCFA 1500)
• Conversion of the proprietary electronic format to the ASC X12N 837 v.4010A1 format
• Conversion of Medi-Cal interim codes to Physician's Current Procedural Terminology (CPT) Level I codes and Healthcare Common Procedure Coding System (HCPCS) National Level II codes
• Elimination of vision qualifier codes

Purpose of Survey
The purpose of this survey is to solicit information regarding the above-referenced changes from Medi-Cal providers who submit Vision Care claims, whether paper or electronic, and determine the effect of the changes on providers. The survey includes questions about current submission type, readiness, conversion timeline, training, beta testing and technical assistance and requests provider opinions regarding Internet Professional Claim Submission (IPCS) direct data entry online form and the Point of Service (POS) device. The survey will be available to Vision Care providers from August 1 through August 31, 2005.

For more information, providers may call the Telephone Service Center (TSC) at 1-800-541-5555, 8 a.m. to 5 p.m., Monday through Friday.