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Provider Handbook
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Military Health System Notice of Privacy Practices
HIPAA Transactions and Code Sets |
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Military Health System Notice of Privacy Practices |
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The MHS Notice of Privacy Practices informs beneficiaries how PHI may be used or disclosed. It describes safeguards in place to protect it and the patients' rights regarding PHI. The notice has been published in nine languages, including Braille, and an audio version is available for vision-impaired beneficiaries.
Privacy officers are located at every MTF. They serve as beneficiary advocates for privacy issues and will respond to inquiries from TRICARE beneficiaries regarding their PHI. Beneficiaries may contact their privacy officer if they have questions about the notice of privacy practices or about their privacy rights. Beneficiaries may also visit the TRICARE HIPAA Web site for more information about the notice of privacy practices or other HIPAA requirements. Specific questions about HIPAA may be sent via e-mail to Privacymail@tma.mil.
If you or your staff would like copies of the MHS Notice of Privacy Practices, visit the TRICARE Web site and select "Notice of Privacy Practices".
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HIPAA Transactions and Code Sets |
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The HIPAA Transactions and Code Sets Rule has mandated the use of electronic standards for certain administrative and financial health care transactions. Compliance with this rule was mandated for October 16, 2003.
Figure 2.1 lists the mandated HIPAA electronic transactions.
The MHS and the TRICARE program are now HIPAA compliant with standard transactions and code sets. Where these business functions are performed electronically, the HIPAA standards are now in use. For more information, visit the TRICARE HIPAA Web site.
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HIPAA Electronic Transactions |
Fig. 2.1
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Transaction No.
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Transaction Standard
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| X12N 270/271 |
Eligibility/Benefit Inquiry and Response |
| X12N 278 |
Referral Certification and Authorization |
| X12N 837 |
Claims: (Institutional, Professional, and Dental) and Coordination of Benefits (COB) |
| X12N 276/277 |
Claim Status Request and Response |
| X12N 835 |
Payment and Remittance Advice |
| X12N 834 |
Enrollment/Disenrollment in a Health Plan |
| X12N 820 |
Payroll Deduction for Insurance Premiums |
NCPDP
Telecom Std. Ver. 5.1 |
Retail Pharmacy Drug Claims, COB, Referral Certification and Authorization, Eligibility Inquiry and Response |
NCPDP
Batch Std.
Ver. 1.1 |
Retail Pharmacy Drug Claims, COB, Referral Certification and Authorization, Eligibility Inquiry and Response |
| TBD |
Claims Attachments |
| TBD |
First Report of Injury |
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