What is EHNAC Healthcare Network Accreditation?

EHNAC Healthcare Network Accreditation indicates that a value-added network (VAN) or electronic health network has met or exceeded EHNAC's performance criteria for EDI - a combination of speed, accuracy, and data integrity. EHNAC accreditation is based on independent peer evaluation of an entity’s ability to perform at levels based on industry-established criteria. The accrediting process permits applicants to review their existing performance levels and to bring those levels into accordance with industry-established minimums and the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (Public Law 104-91). Back to Top

What entities can become accredited?

EHNAC provides accreditation to third-party entities such as electronic health networks that electronically exchange healthcare data – whether independent organizations or divisions of parent corporations. These entities include electronic health networks, payers, financial services firms, third party administrators, medical billers, health information exchanges and e-prescribing solution providers.

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Why should we consider becoming EHNAC accredited?

EHNAC is recognized by the industry for quality of process and value of on-site reviews and recommendations; furthermore, the organization is federally recognized as a standards development organization (SDO). The Maryland Healthcare Access Commission (MHCC) and New Jersey Department of Banking & Insurance (DOBI) recognize EHNAC and its accreditation programs.

EHNAC accreditation benefits organizations by:

• Providing a foundation for current and reusable policies and procedures.
• Assisting with HIPAA compliance.
• Helping to improve performances, quality metrics and measurements.
• Promoting industry best practices in healthcare EDI.
• Identifying security and business risks/exposures.
• Facilitating business discipline, organizational planning.
• Improving customer satisfaction.
• Helping to identify areas to reduce operational costs.

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What is the value proposition for an organization considering EHNAC accreditation?

EHNAC has developed a return-on-investment (ROI) model for companies to use in assisting with the determination of the value proposition of EHNAC accreditation. This spreadsheet is a 'sample' sheet to give an example for how the model can be used and a 'template' sheet to determine the ROI for a specific organization.

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How does my organization become accredited?

Our accreditation process is outlined in full detail in our accreditation guidelines. The first step is to answer the questions in the pre-application form located on the EHNAC Web site.

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How do I know what program(s) to apply for?

To learn which EHNAC Program(s) is right for your organization, visit our Program Page to review the various programs or use the Program Selection Guide.

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How do I find out if an organization is accredited?

Parties with an interest in the current status of EHNAC accredited entities are directed to the Accredited Companies section of the EHNAC Web site. EHNAC endeavors to publish on the Web site, in a timely manner, additions to accredited entities and accreditation status. EHNAC does not provide, in response to inquiries, individual reports on additions to accredited entities and changes in accreditation status. Organizations seeking such information should periodically check the EHNAC Web site. Back to Top

What functions in an electronic health network are measured by EHNAC's criteria?

The criteria are a specific and detailed measurement of many aspects of electronic health network practices, procedures and assets. Functional areas addressed include technical performance, privacy and confidentiality, business practices, resources and security.

The criteria look to the candidate's fixed assets for the handling and processing of electronic data as well as backup capacity. The candidate must have sufficient asset capability to comply with the vigorous standards demanded by EHNAC's criteria. EHNAC also examines the candidate's procedures for training its workers on all technical requirements and privacy and security aspects of HIPAA. Existence of the appropriate trading partner, business associate agreements and personnel manuals are screened and verified. Finally, EHNAC staff visits the candidate's site to verify the accuracy of the reporting and to develop suggestions for improvement.  Back to Top

How will the proprietary information we submit to EHNAC be kept confidential?

EHNAC goes to great lengths to ensure that confidential information remains confidential, and has never had a breach of confidentiality since becoming established in 1993. The Confidentiality Measures section contains the details of how EHNAC works to protect their confidential and proprietary information submitted.
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How does EHNAC develop criteria?

The recognition and adoption of EHNAC's criteria is conducted in a transparent and predictable method pursuant to EHNAC's criteria development process. Certain industry benchmarks are recognized to represent a dynamic and timely compilation of those privacy and security practices, employee training programs, fixed assets, back-up and contingency planning and other performance factors that should be achieved by any entity that functions as a medical information electronic health network. These benchmarks are memorialized in EHNAC's criteria and a candidate's performance and capacity are measured against those standards. Back to Top

How are the criteria adopted?

The proposed criteria appear on EHNAC's Web site and are emailed to all interested parties including all accredited entities; candidates for accreditation; persons and entities requesting information on the criteria; and all government and private institutions and agencies that have been identified by EHNAC as having an interest in the electronic transmission of healthcare information by and/or through electronic health networks. This includes: United States Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office for Civil Rights (OCR), National Uniform Billing Committee, National Uniform Claim Committee, American Dental Association (ADA) and the National Council of Prescription Drug Programs.

Prior to adoption of any criteria, EHNAC has a 60-day comment period. During that period of time, all interested parties are encouraged to review, assess and comment on the proposed criteria. After the comment period has closed, public comments will be reviewed and adjustments in the criteria will be made as deemed necessary. Throughout the entire process, public participation is invited and encouraged. EHNAC seeks to recognize and adopt those standards which represent the essential facility practices and standards that are often typically achieved by a well functioning and reputable electronic health network that complies with appropriate state and federal obligations. Back to Top

How can my organization participate in establishing criteria?

EHNAC welcomes the participation of all parties interested in the healthcare transactions industry. A permanent criteria committee meets periodically to review and update EHNAC criteria. If you are interested in participating on the criteria committee, contact the committee chair.

Nominations for commissioners should be directed to the nominating committee chair. As commission slots become available, the chair conducts interviews with interested candidates in accordance with the mix of participants outlined in the EHNAC Bylaws.  Back to Top

Is a unanimous vote of the commissioners required for accreditation?

No. A simple majority vote is required for approval of all accreditation issues. Back to Top

Is there a representative assigned during the accreditation process?

A site reviewer is assigned after the application process has been completed. Questions can be submitted to the site reviewer while the Self-assessment is being completed.

You may email questions to the site reviewer prior to the site visit. Please include the entire text of the criteria in question, including the statement of the criteria and the detail from the link. This detail is important to properly address questions in their entirety and to minimize any lack of clarity in responding appropriately.  Back to Top

Must an organization use the provided Disaster Recovery Plan template?

No, this is meant to be a sample only for those that wanted ideas on how to set it up. We understand that different companies must approach this differently. Back to Top

What are the costs associated with becoming accredited?

Organization fees are determined by revenue. This revenue from an organization is defined as any services performed either electronically or paper-based that supports the program which includes all electronic transactions, patient statements, customer service, infrastructure, technical performance, business practices, privacy and security and resources. Below are the costs for both initial and additional programs:

An additional program fee is charged with the site visit fee with each accreditation.
Travel expenses are not included and will be submitted to you after the site visit(s).
For organizations with multiple facilities that operate the same functions under the same policies and procedures such as lockbox facilities, a site visit rotation will be used to accredit the candidate as follows:

In addition to the above, when the self-assessment process requires subsequent resubmissions of documentation to meet the criteria after the site visit is completed, there will be a charge of $200/hour for site reviewer time for each additional submission of documentation.

Re-accreditation fees for all programs are the same as accreditation fees.Back to Top

What is the discount agreement with CAQH CORE?

As of June 1, 2009, CORE certified entities can take advantage of a one-time discount for CORE Phase I and/or Phase II certified entities. The partnership program discount is $400 for organizations with annual revenue below $75 million, and $600 for organizations with annual revenue above $75 million. The entity will indicate that it is CORE Phase I and/or Phase II certified when submitting its application. (EHNAC will confirm CAQH CORE certification status independently.) View http://www.caqh.org for more information about CORE certification.

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Must a company pay the site visit fees at the time of the annual fee in an
accreditation year?

Some companies submit site visit fees with their annual fees; however, that is not necessary. The company must pay the site visit fees prior to application completion. Consequently, the self-assessment documentation will not be provided until the application is complete, which will limit self-assessment time period.
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What is the timeframe for the accreditation process?

Accreditation timeframes vary depending on the size of your organization, although most organizations complete the process within 6 to 8 months. Please click here for a sample timeline for both first time applicants and re- applicants. Applicants are given 12 months from the date of application approval to complete the accreditation process. The self-assessment must be submitted 4 months prior to the end of the 12 month time limit.

EHNAC has also developed a sample project plan tool outlining the steps in accreditation. This can be used by an organization as a starting point to be customized as appropriate.  Back to Top

What happens after my application is approved?

Upon receipt of your application fee and commission approval, your organization or corporation receives candidate status. Once you receive candidate status, you will be sent the EHNAC Accreditation Candidate logo. You have the right to use the following EHNAC-approved designation:

"[Candidate] [organization or corporate] has been granted CANDIDACY STATUS by the Electronic Healthcare Network Accreditation Commission (EHNAC). This status is granted only to entities whose applications have been carefully reviewed by the commission, who the commission believes to be in substantial compliance with its criteria and who are likely to qualify for provisional, interim or full accreditation within one year of the granting of Candidacy Status."

The Accreditation Guidelines containing the rules of the accreditation program, commission guidelines, approved uses of all commission designations, and other program information that is available on the EHNAC Web site for your reference. You will also receive the Self-Assessment guidelines and report, which explains the criteria for accreditation as well as the required supporting documentation. The site visit fee is due fifteen (15) days prior to the scheduled visit to your site.  Back to Top

How long does accreditation last?

Accreditation is granted for two (2) years. Organizations must then re-apply. Back to Top