Update on HIPAA Compliance
Delta Dental has designated compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Administrative Simplification mandates as one of its primary priorities and continues its efforts to comply accordingly.
Electronic Transaction Standards – Compliance Date January 1, 2012
Delta Dental is addressing the requirement to update the electronic transactions from the 4010 version to 5010. Compliance upgrades are broken into phases, designed to meet the compliance date of January 1, 2012.
Phase I – Gap Analysis and Impact Assessment – Completed
- Assessed impact of the changes to each transaction on our technical and business processes.
Phase II – Systems & Business Process Design Solutions – In Progress
- Use gap analysis and impact assessment to identify and design systems and business process solutions.
Phase III – Implement System and Business Process Solutions
- Conduct internal testing of systems and business processes.
- Conduct external testing with trading partners.
- Deploy systems and business process solutions into production by January 2012, as required by the rule.
Data Code Set Standards – Compliance Date October 1, 2013
Delta Dental is addressing the requirement to adopt the ICD10-CM Diagnosis Coding as required for dental claims processing.
Phase I – Business Requirements and Impact Assessment – In Progress
- Collect business requirements and assess impact of the ICD10-CM as they apply to dentistry for purposes of claims processing and other related uses.
Phase II – Business Process Solutions and Dental Policy Provisions
- Apply dental policy provisions and impact assessment to design business process and dental claims processing solutions.
Phase III – Implement System and Business Process Solutions
- Conduct internal testing of business processes.
- Conduct external testing with trading partners.
- Deploy business process solutions into production by October 2013, as required by the rule.