The issue of Trading Partner Agreements arose in the Business Issues Teleconference yesterday. Discussion led me to believe that it's still unclear whether paper Trading Partner Agreements will be needed or desirable under HIPAA. For background, you should definitely look at the WEDi document "Trading Partner Agreements: A White Paper Describing the Business Issues and Recommended Solutions Associated with Trading Partner Agreements," by Doug Renshaw. It's available under "Transactions Workgroup White Papers" at the WEDi/SNIP site at http://snip.wedi.org/public/articles/Trading113000.pdf.
The topic came up because one of the callers wanted to know how - other than by using a TPA - a sponsor (employer) would know whether to send to the payer a full compilation of enrollees, vs. just the changes since they last "talked." Other things a TPA might be required to resolve are the situations (as in "situational") where data is expected or desired. Fortunately, there seemed to be nothing in the discussion of a legal nature - i.e., everything was technical, which means a mechanical or electronic Trading Partner Agreement might suffice. Besides these issues the caller brought up, I wanted to see what Doug and his team came up with. His document is an excellent compendium of the situations calling for agreement ahead of time. But, fortunately, I saw nothing which could not be mechanized! Though he had the usual stuff like specifying communication protocols, Clearinghouse designations, and agreements on maximum numbers of claims (e.g., 5000 claims in the 837), he mentioned nothing that would require Lawyer Man to get in the way of real business. I probably can't emphasize enough how paper TPAs will gum up the works in automated partner recruitment - to the point where our work in the WEDi/SNIP ID & Routing Special Interest Group might be rendered moot. What's the point of automated "discovery" of trading partner technical requirements (communications and protocols) if that stuff may as well travel with the paper TPA? Marcallee Jackson has confirmed that signed paper TPAs would involve so much overhead that they "will cause the labor costs associated with EDI enrollment to sky rocket." Rachel Foerster has also related the story of the (bad) experience with TPAs when required by the Federal Government. Even though we have sub-projects for looking seriously at the ebXML CPP (basically a mechanical Trading Partner Agreement or Profile) and the 838 - led by Dick Brooks and Dave Minch, resp. - I'm suggesting that we move the concept of Electronic Trading Partner Agreements to the front-burner. If we can mechanically represent in them everything Doug has enumerated in the white paper, we'll be better prepared to fight the conservative tendency to require paper TPAs. Electronic Trading Partner Agreements fit into our scheme quite elegantly, in that Kepa's DNS "directory" would be used to find a trading partner's profile based on identifier. The profile itself would, in addition to the stuff mentioned in the white paper, have the technical routing information for interchanges. In effect, you'd be "discovering" electronic trading partner agreements, not "inboxes," "portals," or "front doors." William J. Kammerer Novannet, LLC. +1 (614) 487-0320
