133 Aetna Requires Electronic Claims
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Dynamic Chiropractic – September 1, 2003, Vol. 21, Issue 18

Aetna Requires Electronic Claims

Latest Update Confirms Providers ARE "Covered Entities"

By Editorial Staff
An article in the July 14, 2003 issue of Dynamic Chiropractic1 reported Aetna was sending out notices to its providers, informing them that:

"Effective September 15, 2003, you will be required to send all Aetna claims electronically." [emphasis added]

While the action appeared to be universal, DC was informed by Aetna that these notices have thus far only been sent to providers in California and Texas.

Aetna has declined to state a specific date when it will require all providers to process their claims electronically, but it is abundantly clear that the time is coming soon, depending on the state in which you practice.

Based on initial reaction to the Aetna notices, other payers are expected to follow suit, particularly considering that the extended deadline for HIPAA-compliant claims protocols is October 16, 2003.

In communications with DC, Aetna also confirmed that its providers are "covered entities":

"Aetna 's participating providers are 'covered entities' in their own right, and are not our business associates. We have kept them updated on Aetna's overall HIPAA Privacy compliance efforts, both to advise them of Aetna's readiness and as a reminder of HIPAA's upcoming expectations."2

This is an issue about which many doctors of chiropractic have been extremely confused. Many have felt they could avoid covered-entity status based on their number of staff or whether they processed claims electronically.3

By confirming that its providers are covered entities, as defined by the HIPAA laws, Aetna leaves little doubt as to the responsibility of every doctor to become HIPAA privacy and security compliant. This is even more relevant to those who have not become HIPAA compliant, as the deadline for compliance of the HIPAA privacy standards was April 14, 2003.4,5

References

  1. Aetna mandates electronic claims submission. Dynamic Chiropractic, July 14, 2003. www.chiroweb.com/archives/21/15/01.html.
  2. Electronic communications with Karin Rush-Monroe, Aetna Business Communications, July 18, 2003.
  3. Top 12 misconceptions about HIPAA compliance. Dynamic Chiropractic, July 28, 2003. www.chiroweb.com/archives/21/16/07.html.
  4. The deadline for compliance with the HIPAA privacy rules is approaching. Dynamic Chiropractic, Feb. 24, 2003. www.chiroweb.com/archives/21/05/02.html.
  5. Everything you ever wanted to know about HIPAA - but may still be afraid to ask. Dynamic Chiropractic, Nov. 30, 2002. www.chiroweb.com/archives/20/25/09.html.


Dynamic Chiropractic editorial staff members research, investigate and write articles for the publication on an ongoing basis. To contact the Editorial Department or submit an article of your own for consideration, email .

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