Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior to the compliance dates for transaction standards and code sets specified in 42 CFR Part 162 – Health Insurance Reform: Standards for Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s written verification for the applicable item(s).
Appears in 1 contract
Samples: Ohio Medical Assistance Provider Agreement (Centene Corp)
Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior to the compliance dates for transaction standards and code sets specified in 42 CFR Part 162 – Health Insurance Reform: Standards for Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s written verification for the applicable item(s).
Appears in 1 contract
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan
Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated demonstrated, to the satisfaction of ODJFS, as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior verification to the compliance dates ODJFS for transaction standards and code sets specified in 42 45 CFR Part 162 – - Health Insurance Reform: Standards for Appendix C Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s 's written verification for the applicable item(s).
Appears in 1 contract
Samples: Ohio Medical Assistance Provider Agreement (Wellcare Health Plans, Inc.)
Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated demonstrated, to the satisfaction of ODJFS, as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior verification to the compliance dates ODJES for transaction standards and Appendix C code sets specified in 42 45 CFR Part 162 – - Health Insurance Reform: Standards for Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s 's written verification for the applicable item(s).
Appears in 1 contract
Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior to the compliance dates for transaction standards and code sets specified in 42 CFR Part 162 – - Health Insurance Reform: Standards for Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s 's written verification for the applicable item(s).
Appears in 1 contract
Samples: Provider Agreement (Centene Corp)
Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated demonstrated, to the satisfaction of ODJFS, as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior verification to the compliance dates ODJFS for transaction standards and code sets specified in 42 45 CFR Part 162 – Health Insurance Reform: Standards for Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s written verification for the applicable item(s).
Appears in 1 contract
Samples: Medical Assistance Provider Agreement (Molina Healthcare Inc)
Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated demonstrated, to the satisfaction of ODJFS, as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior verification to the compliance dates ODJFS for transaction standards and code sets specified in 42 45 CFR Part 162 – - Health Insurance Reform: Standards for Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s 's written verification for the applicable item(s).
Appears in 1 contract
Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated demonstrated, to the satisfaction of ODJFS, as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior verification to the compliance dates ODJFS for transaction standards and Appendix C code sets specified in 42 45 CFR Part 162 – Health Insurance Reform: Standards for Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s written verification for the applicable item(s).
Appears in 1 contract
Samples: Molina Healthcare Inc
Documentation of Compliance with Mandated EDI Standards. The capacity of the MCP and/or applicable trading partners and business associates to electronically conduct claims processing and related transactions in compliance with standards and effective dates mandated by HIPAA must be demonstrated as outlined below. Appendix C Verification of Compliance with HIPAA (Health Insurance Portability and Accountability Act of 1995) MCPs shall submit written verification, prior to the compliance dates verification for transaction standards and code sets specified in 42 45 CFR Part 162 – - Health Insurance Reform: Standards for Electronic Transactions (HIPAA regulations), that the MCP has established the capability of sending and receiving applicable transactions in compliance with the HIPAA regulations. The written verification shall specify the date that the MCP has: 1) achieved capability for sending and/or receiving the following transactions, 2) entered into the appropriate trading partner agreements, and 3) implemented standard code sets. If the MCP has obtained third-party certification of HIPAA compliance for any of the items listed below, that certification may be submitted in lieu of the MCP’s 's written verification for the applicable item(s).
Appears in 1 contract
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)