Kepa, It already is on our agenda for tomorrow, as part of your update on "Contingency Planning"! Anyone interested should tune in. There should be an announcement coming out later today which should include the call-in data.
- Zon - ----- Original Message ----- From: "Kepa Zubeldia" <[EMAIL PROTECTED]> To: "Koller, Greg" <[EMAIL PROTECTED]>; "'Christopher J. Feahr, OD'" <[EMAIL PROTECTED]>; "George Kaye" <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]> Sent: Monday, April 15, 2002 5:18 AM Subject: Re: Code Set effectivity compliance testing > Greg, > > That is a great approach. I proposed a staged implementation back in 1998, > but was summarily rejected in favor of the all or nothing approach. > > I think (for whatever that is worth :-) that there should be flexibility. > Some trading partners may want to start sending/receiving a "relaxed" version > of the HIPAA transactions now, and then start tightening it as time goes by. > For instance, where the guide does not explicitly forbid something, let's > have some flexibility. > > One example: What if the Place of Service in the service line (Loop 2400) is > the same as the Place of Service in the 2300 loop (claim level)? The guide > says that the POS at the service line is sent when it is different than the > one at the claim level. The strict interpretation is that if it is the same > in both places, you don't send it at the service line. But, what is the harm > if you do send it at the service line? They are the same, right? So there > is no confusion. For a transitional time we should relax these requirements. > There are many more examples. Then, once people are using these > transactions, as an industry we could tighten the requirements one step at a > time. > > We are conducting an experiment with Claredi customers. On April 1st we > released, for our customer's use, a version of the testing and certification > system that uses this "relaxed" approach to compliance. Where the normal > (strict) compliance requirements would make a transaction fail, the "relaxed" > version will pass with a "business error" or "warning". The "relaxed" > version is based on our interpretation of the TG8 Opinion letter. So far it > has only been two weeks, but the "vote" seems to be that the Claredi > customers are choosing the "strict" analysis over the "relaxed" analysis by a > factor of 20:1. This is shocking. I was expecting it to be the other way > around. We will see what happens after one full month. Claredi's customers > are the experts, pioneers, and early adopters, so our population is probably > biased and favors the more strict interpretation of the guides. > > For entities that are mapping from NSF to the 837, and for clearinghouses, I > think the relaxed edits is the best way to go. As the data stream improves > in data content and providers migrate away from the NSF as an intermediate > format, the requirements can be better aligned with the letter of the > implementation guides. > > So, the staged approach that you are talking about makes a lot of sense. The > trick is that the entire industry would have to agree to have approximately > the same interpretation of what a staged approach means. If we could get > some of the largest clearinghouses (you know who you are) on board with this > concept, maybe SNIP could coordinate some sort of white paper on what would > be the staged approach to compliance. I have been involved in some > conversations in this area that seem very encouraging. > > Perhaps there should be an option, at least for the transition time until > October 2003, and people could decide whether to transition in one step to > the full strict compliance with the guides, or through a series of more > relaxed compliance steps. The problem is that if you have thousands of > systems to adjust, you don't want to adjust them several times. OK, then do > it in one step. Your choice. > > Is this a topic we could put in the agenda for the Business meeting tomorrow? > > Kepa To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address. The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
