The Centers for Medicare and Medicaid Services [CMS] published another proposed HIPAA rule in September of 2005 for the first six electronic claims attachments. Claims attachments are the clinical data and reports that a health plan can ask your doctor, or other health care provider, when they need additional information on a claim of medical services provided to you.
A claims attachment is a combination of administrative information and clinical information, such as a procedure code. Its purpose is to bridge the gap between billing and medical records functions. When asking for an electronic claims attachment each health plan must ask the same clinical questions of all providers. The claims attachment goal is to permit quicker payment by health plans. In other words, your doctor will get paid for your services faster with this HIPAA rule.
The Six Claims Attachments
The six standardized claims attachments cover the areas that are the most requested by health plans today. The claims attachments in this HIPAA rule are for:
- Ambulance,
- Emergency Department,
- Rehabilitative Services,
- Lab Results,
- Clinical Reports, such as
- Operative notes,
- Discharge Summaries,
- Clinical Notes, and
- Medications.