PASSPORT Provider HIPAA Billing Formats

The use of standardized transactions and code sets mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will have a major impact on health care providers who do business electronically, as well as many of their health care business partners. The Ohio Department of Aging and the PASSPORT Administrative Agencies are committed to compliance with HIPAA regulations.

The PASSPORT system will support three methods of submitting invoice claims under HIPAA: Electronic Data Interchange (EDI); Direct Data Entry (DDE); and paper.

EDI is the electronic exchange of formatted data. Of the eight EDI transactions approved for HIPAA, PASSPORT will be using the claims, remittance advice and acknowledgment transaction sets. Business rules and requirements for setting up an EDI transaction are detailed in implementation guides.
DDE will replace the Data Entry Module (DEM) currently used by many PASSPORT providers. Unfortunately, DEM does not meet the requirements for HIPAA compliance. DDE operates similarly to the DEM but is Web-based and HIPAA compliant.
Providers who choose to submit paper invoice claims will continue to work with the PASSPORT Administrative Agency billing staff as in the past.

ODA hopes as many providers as possible take advantage of the available electronic claims submissions options instead of paper. Thank you for your assistance in helping Ohio's aging network make the transition to the HIPAA compliant billing format.