The North Carolina Medical Society recommends that you first contact the appropriate trading partner and/or third-party payor to learn more about the problem you are experiencing with your claims. It is important to ask a lot of questions and to gather as much information as possible about the issues you are having.
If the problem does not get resolved, you can file a complaint through the federal Office of E-Health Standards and Services (OESS), which enforces HIPAAs Administrative Simplification provisions. To file a complaint, access OESSs online Administrative Simplification Enforcement Tool. The first time you file a complaint, you will need to create an account. Once you have done so, click on "New Complaint." The tool will then lead you through a series of prompts, asking for information about the entity that you are complaining about.
Review the AMA's Frequently Asked Questions
Visit the Centers for Medicare & Medicaid Services (CMS) ICD-10 website
Review the Final Rules
North Carolina Healthcare Information and Communication Alliance (NCHICA) [www.nchica.org]
North Carolina Health Information Management Association (NCHIMA) [www.nchima.org]