HIPAA - Employer

Welcome to the Tufts Health Plan HIPAA Web page for employer groups, brokers and consultants. This site is designed to provide you with information regarding our HIPAA's Administrative Simplification Regulations. You will also find information on how these regulations effect and impact the employer and broker communities, including an extensive array of information about the Privacy Regulations.

Tufts Health Plan is Committed to HIPAA
It's no secret - HIPAA is a complex piece of legislation that has a huge impact on everyone involved with the health care industry, including employers, brokers and consultants.

We are committed to achieving compliance with the Administrative Simplification portion of HIPAA. Through the work of our HIPAA Program Office, many activities have been completed, and more are in progress, to make certain we comply with HIPAA's Privacy, Transactions and Code Sets and Security Regulations.

The following grid outlines the most up-to-date information we have regarding timelines for our Transactions and Code Set compliance efforts and it provides you with links to our existing companion documents. Please take a moment to review this grid to become more familiar with our schedule.

Tufts Health Plan HIPAA Transactions and Code Sets Implementation Calendar
Transaction	EDI (direct & clearinghouse)
	Test	Migration
837 Health Care Claim: I&P (click here for companion document)	Complete	Complete with the exception of 1 clearinghouse
835 Payment Advice (click here for companion document) The Tufts Health Plan Medicare Preferred 835 transaction is scheduled for completion in December 2004	Complete	Complete
270/271 Eligibility, Inquiry and Response (click here for companion document)	Complete	Complete
276/277 Claims Status Inquiry and Response (click here for companion document)	Complete	Complete
278 Specialty Referral (click here for companion document)	Complete	Complete
834 Benefit Enrollment and Maintenance (download the companion document, reference guide and the submitter aide)	Complete	Complete
820 Payroll Deducted and Other Group Premium Payments (click here for companion document information)	Complete	Complete

For an update on how our HIPAA Project Office has progressed with its efforts to reach compliance with the HIPAA regulations, and for some additional information on what you may need to know about these regulations, please read our Tufts Health Plan HIPAA Readiness Update.

Electronic Date Interchange (EDI) Submitter Information
This section provides information on how to obtain our companion guide documents for the 834 Benefit Enrollment and Maintenance transaction, and the 820 Payroll Deducted and Other Group Premium Payment transaction.

HIPAA Privacy Documents
This section is designed to provide employer groups, brokers, consultants and third party administrators with information regarding the Privacy Regulations and how they impact their relationship with Tufts Health Plan. This includes summary documents for fully- and self-insured employer groups, instructions for brokers and consultants and Tufts Health Plan-specific Agent and Business Associate Documentation forms.

Summary of Privacy Information
This area describes a member's rights under HIPAA and what Tufts Health Plan is doing to be in compliance with the Privacy Regulations.

HIPAA Web Links
We have developed a resource list of helpful HIPAA-related Web sites for Transactions and Code Sets, Privacy and Security Regulations.