Thanks for everyone's comments. To clarify the entity in question is a
Billing & Collection Agency. So it has only provider clients. Based on
everyone's input I conclude that this CE would not need any BA agreements
with the payors to whom it submits claims. However, it would need BA
agreements with its providers as the CE is the BA of the provider. Is that
correct?

Regards,
Vikas

-----Original Message-----
From: Leslie C. Bender [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, September 04, 2002 12:54 PM
To: [EMAIL PROTECTED]; Jamelle T. Magee
Subject: RE: A Question about Business Associate Agreements


Are we all working from the same original facts?  I read the original post
to say that one entity, a clearinghouse/billingagency/collection agency, was
in the vortex of a series of transactions and wanted to know if it needed BA
agreements with providers and payors that it found itself in the middle
of -- not that there were 3 separate companies.  I apologize if I
misinterpreted the back slashes in the post -- but I didn't see the question
as 3 separate entities asking if each fit the BA definition and how..

Clearly a collection agency working for a payer needs no BA agreement with a
provider (that isn't its client) and the converse is true as well.
Similarly a medical billing company working for a provider is its BA -- but
is not a payor's BA because it handles an outsource of the provider's
insurance billing and follow up functions (which equate to "payment" in
HIPAA).

To me the results change if you have one entity interchangeably being
clearinghouse/billing company/collection agency -- performing multiple tasks
through one corporate entity for the same group of provider and payor
clients (e.g., it isn't a hybrid, doesn't have separate corporate
affiliates...)

Leslie Bender


---------- Original Message ----------------------------------
From: "Jamelle T. Magee" <[EMAIL PROTECTED]>
Date:  Wed, 4 Sep 2002 09:59:30 -0400

>
>
>
>
>
>
>WE know that a BA relationship exists b/t provider and clearinghouse and
>no BA relationship exists b/t provider and health plan, per regs.  I
>believe that like the provider, no BA relationship would exist b/t the
>clearinghouse and the health plan.  However, I have been known to be
>conservative when designating BAs.  What's your reasoning Leslie?
>
>
>
>    Jamelle
>
>Jamelle T. Magee, JD
>
>Privacy Officer
>
>UNC Chapel Hill Student Health Service
>
>v. 919.843.2584
>
>
>
>




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