Health Partners HIPAA

Health Partners HIPAA Transactions and Code Sets Frequently Asked Questions

Health Partners HIPAA transactions subject to HIPAA standards set for health care industry. Health Partners HIPAA transactions FAQs may be useful both for new vendors and new partners who are going to exchange Health Partners HIPAA transactions. Find the first part of Health Partners HIPAA transactions FAQs below.

Q: Does Health Partners Plans require certification/testing with providers?

A: Health Partners Plans does not require providers to certify with Health Partners Plans directly. Providers, their billing software vendor and/or EDI clearinghouse must be certified with Health Partners Plans EDI clearinghouse, Emdeon. Health Partners Plans encourages its providers to work with Emdeon and their EDI clearinghouse and/or billing software vendor to ensure that the electronic transactions they send meet the HIPAA requirements.

Q: Do providers need to test with Health Partners Plans if they utilize an EDI clearinghouse to process their transactions?

A: Providers should provide their EDI clearinghouse and/or billing software vendor with a copy of the Health Partners Plans Companion Guide for each transaction. If the billing software vendor or EDI clearinghouse utilized has already been certified by Emdeon, additional testing should not be necessary.

Q: How can providers obtain copies of Health Partners Plans’ Companion Guides?

A: All Companion Guides are available on the Health Partners Plans website: under “Eligibility & Claims –HIPAA CONNECT/EDI CLAIMS, HIPAA Companion Guides.”

Q: Who can we contact at Health Partners Plans if we have Transaction and Code Sets or EDI questions?

A: If you have questions regarding electronic billing or transaction and code sets, you contact the Health Partners Plans EDI Support Line.

Q: Does Health Partners Plans have a Contingency Plan?

A: Yes, Health Partners Plans has developed a Contingency Plan to address the needs of provider community. The plan follows the direction established by the Centers for Medicare and Medicaid Services (CMS) and the State of Pennsylvania Department of Public Welfare (PA DPW). Health Partners will continue to accept transactions in both the legacy and HIPAA standard formats for a limited period of time.

Q: Has Health Partners Plans implemented their Contingency Plan? If so, how long will it be in effect?

A: Health Partners has made the decision to implement our Contingency Plan. Health Partners Plans will work with providers during this transition period, and will establish a final transition date based on the readiness of the providers. For more information on the Contingency Plan, please go to the Health Partners Plans website: http://www. under “Eligibility & Claims – HIPAA CONNECT/EDI CLAIMS, Contingency Plan Announcement.”

Vendors should regulary check the news and updates to have the latest actual information.

Leave a Reply

Your email address will not be published.

Post Navigation