How will HIPAA change shadow claim processes for the MCOs?
(3/2002) At this time, the OMPP anticipates that all shadow claims, also known as encounters, will be required to be submitted on the standard format named in the August 17, 2000, rule. For example, the professional health care service encounter will be submitted from the MCO to EDS via the 837 professional encounter transaction. By using the 837 transactions for shadow (encounter) claim reporting, MCOs have the capability to report shadow claim adjustments electronically.
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- How will HIPAA change shadow claim processes for the MCOs?
