HIPAA complaint form

If you experience problems related to compliance with the provisions of the Health Insurance Portability and Accountability Act (HIPAA) Transaction and Code Set Standards, you can indicate such problems on this complaint form. Health payers and clearinghouses must be able to process claims in HIPAA-compliant electronic formats. Information gathered through the complaint form is critical to help the AMA identify and combat the regulatory noncompliance of covered entities.

Modifications have recently been made to this form that take into account changes in the marketplace, such as recent mergers and acquisitions, as well as the greater level of complexity that has been introduced into the physician practice.

To ensure the confidentiality of your submission, please do not provide us with any "Protected Health Information" about any of your patients.

Completion of the form is voluntary and confidential. The AMA intends to share aggregated information with the Centers for Medicare and Medicaid Services (CMS), the agency responsible for enforcing the new HIPAA electronic transaction and code set requirements. CMS may use data to help guide its enforcement actions. The AMA will also use the data to keep AMA leaders, members, medical societies, the media and other interested parties abreast of HIPAA compliance issues and to advocate on the behalf of physicians. Additionally, the AMA may pursue compliance activities with individual plans, payers or clearinghouses where a pattern of complaints warrants. Since the form is filled out anonymously, neither the AMA nor CMS will respond to individual complainants. Although the AMA plans to share aggregate complaint information with CMS, please be aware that completing this form does not constitute filing a complaint with CMS. If you wish to file a complaint, you may do so on the CMS Web site.

CMS issued an announcement relating to a delay in payment of non-HIPAA compliant claims. Learn more about the CMS announcement regarding the future of the HIPAA Transaction and Code Set contingency plan.

Security

One of our top priorities at the AMA is to ensure the validity and security of the electronic transmission of information. (See Privacy Statement).

For all electronic submissions of the HIPAA Complaint Form, the use of cookies is required (for information on cookies, see item 12 under the "Privacy" heading).

Access the HIPAA Complaint Form.