I can vouch for Kepa's comment regarding many payers. We are a relatively small Health System, but we have over 2000 payers in the insurance table of our largest provider. Even if I assume that each company has at least 1 alias, that still leaves over 1000 profiles. That means if I want to send directly to each payer, I need to negotiate 1000 TPAs, perform 1000 tests, set up 1000 trading profiles, and implement however many unique transports to deliver the claim payloads to the "first hop" recipients. And I'm just 1 provider (well, actually 15) -- think of how many of us are going to be knocking at the payer's doors. Are you guys ready???
Then I shall simply pray a whole lot that if any one of the links in this frighteningly fragile chain of mail carriers decides to change transports, methods, passwords, encrypting, etc. that they give us good advance notification, and that the information they communicate is accurate, and that they don't decide to change things at the last minute..... Mess?? you got that right! Lets see.... If I can average 3TPAs per day, and get them all set up for testing it should only take me 15 months to get all 1000 ready by 4/16/03. I guess I can just make it if I start tomorrow... Does any of this sound as absurd to anyone else as it does to me????? Dave Minch T&CS Project Manager John Muir / Mt. Diablo Health System Walnut Creek, CA (925) 941-2240
