Contents

• Cover Letter (PDF 63k)
  Letter to all IHS and Site Facilities concerning the compliance packet.
   
• ITSC HIPAA Team Resource Lists (WORD 35k)
  This list provides you with the necessary ITSC resources who can guide you toward becoming HIPAA compliant.
   
• HIPAA RPMS Applications and Patches (WORD 53k)
  This form provides you with a list of current PRMS applications, including each version or patch that will have to be installed on your RPMS system before you can begin testing the various transaction types.
   
  Note: This form will be updated periodically as new software is released. The most updated form can be found here.
  
  
• The following links are to 837 testing and production procedures to transactions with TrailBlazers.
  
  Guidelines for RPMS procedures for the 837 for TrailBlazers Medicare Part A (PDF 160k) and TrailBlazers Medicare Part B (PDF 158k) provide instructions for the initial RPMS set-up, general testing procedures, receiving and reading error reports, how to initiate the production mode, post production mode procedures and contact information for assistance with the process. There are also procedures for Manually Adding Provider Taxonomy Codes (PDF 121k) to RPMS.
  
  
• 835 Transaction Testing and Production Procedures (PDF 434k)
  The 835 Transaction is the HIPAA compliant format that allows for receiving third party reimbursements payments and adjustment information. This training manual provides information on setting-up the 835 Transaction software and testing it with Trailblazer Medicare Part A and B and PNC Bank payers. It also provides information on processing the 835 ERA file and other options of the package.
  
  
• HIPAA EDI Notification (WORD 79k)
  This form will provide valuable information on identifying trading partners/insurers you work with, providing contact information, and providing EDI subscriber-I/T/U/ facility information. It will also list authorized transactions at your area and site, including projected testing date and software requirements. If you are not testing with this Insurer or processing HIPAA compliant formats, it will also identify whether you need to submit a contingency plan for your Insurers.
   
• Sample Copy of a Business Associate Agreement (BA) (WORD 79k)
  This agreement is a contractual agreement. It sets up liability and risks for doing business. The BA Agreement Clause (attachment) is added to safeguard PHI when performing functions and/or services for IHS.
   
  IHS is currently working with Quovadx to put into place a Delivery Order Contract since they currently provide service for five of the major clearinghouses.
   
  Note: If there are questions or concerns, consult with your legal counsel.
   
• Sample copy of Trading Partner Agreement (TPA) (WORD 74k)
  A Trading Partner Agreement (TPA) is a formal legal document validating the legality of the business transactions which will be electronically processed. In the final Transaction Rule, a TPA is defined as “an agreement related to the exchange of information in electronic transactions, whether the agreement is distinct or part of the larger agreement, between each party to the agreement. (For example, a TPA may specify among other things, the duties and responsibilities of each party to the agreement in conducting a standard transaction.)” The attached sample TPA was developed specifically for the IHS.
  
  The Trading Partner Agreement is not a contractual document and does not fit the definition of any standard agreement document used by federal agencies. However, it is an Agency (IHS) Agreement and therefore current IHS delegations of authority apply. If the agreement methodology is used to accomplish this exchange function, you must ensure that the agreement meets Federal/Departmental/IHS standards and all legal requirements (cleared by OGC). The attached sample agreement meets these requirements.
  
  Since this is a new instrument for conducting IHS business, it is recommend that the delegation of authority for signing the agreement remain with the Area Director for at least the first cycle in case there are any “glitches” that may occur in executing the provisions of the document.
  

If you have any questions regarding this packet, please contact Sandra Lahi at 505-248-4206.

Please email questions or comments to HIPAA Web Contact.