I'm working on the Identifiers Working Paper for WEDI/SNIP with Ron
Bowron, and we're trying to put together real examples of Identifiers as
used in the ISA for routing.  I have plenty of NAIC insurance company
codes, and D-U-N-S numbers for hospitals and clinics, and even a few tax
IDs, but have little in the way of HIN (Health Industry Number)
examples.

Working with real examples helps in two ways: (1) it holds one's
attention better to use real examples, instead of saying D-U-N-S xxxx
for Hospital Y, and (2) if you have real good luck finding, say, a
D-U-N-S for every practice and hospital you may have ever been
interested in or heard about, perhaps it means D-U-N-S has great
coverage and we could constrain the routing ID for providers to always
be a D-U-N-S for consistency and simplicity.  This is what RosettaNet
and GISB have done: all trading partners must be identified with their
D-U-N-S.

Some examples follow, with nothing changed to protect the innocent.  The
punctuation typically used to make the printed ID more readable -
consisting of dashes in the D-U-N-S and the FEIN - would not be present
in EDI or our registry.

D-U-N-S:
04-643-0013 - CHILDREN'S HOSPITAL, COLUMBUS , OH
07-164-3589 - RIVERSIDE METHODIST HOSPITAL,COLUMBUS , OH

Federal Tax IDs (FEINS):
23-2229683 - Aetna Inc.
61-0647538 - HUMANA INC.
95-4505291 - UCLA Orthopaedic Surgery Medical Group

NAIC:
68241 - Prudential
60054 - Aetna
54771 - Highmark

HCFA Carrier (Medicare)
16360 - Nationwide - Ohio
00880 - SOUTH CAROLINA BC/BS

The HIN (Health Industry Number) is kind of tricky to locate. I called
HIBCC, the registrar for the HIN, and they wanted $10 for each ID!!! -
even though I told them they were just for some examples in a paper.
You would have thought they would have been grateful I wanted to mention
them at all! I would prefer HIN examples for hospitals, clinics and
other providers, so I would appreciate if someone on this list would
supply me some.  In actuality, if the HIN were going to be used as a
routing identifier, the party identifying itself with a HIN would
probably know what its own ID was. Here are some examples for the HIN:

52F8TXK00 - BAXTER HEALTHCARE
I8IVONE00 - CARDINAL HEALTH INC.
43KEC3K00 - HUMANA HEALTHCHICAGO

I noticed that the 835 guide does not have the ABA Routing Identifier
listed as one of the permissible codes for the Interchange ID Qualifier
in the ISA.  Wouldn't the ABA Routing Identifier typically be used as
the receiver ID for payment orders (835) to banks?  Can you even route a
payment order through a clearinghouse (or VAN) to a bank, or do you
always have to "hook" up with your bank directly? Clearly, the 835 EOB -
containing PHI - should go between the payer and the provider directly,
or through a CE like a clearinghouse.  Are there even any Value-Added
Banks that can handle PHI?

ABA Routing Codes for Banks:
071000013  - BANK ONE, NA, CHICAGO
021000018 - The Bank Of New York

Knowing what your own "name" is begs the question whether your trading
partner can divine the ID you're known by.  Imagine the scenario where a
physician first encounters a patient.  Let's assume Peter Barry's
grandiose plans for insurance cards with National Plan IDs comes to
fruition:  the National Plan ID could be used to search the "National
Plan ID database" to come up with, say,  the NAIC company code of the
payer.  From there, the WEDI/SNIP Registry would be searched on the NAIC
to come up with the WEDI/SNIP CPP (Electronic Trading Partner Profile)
which is used to tell you how to deliver eligibility inquiries and
claims to the payer handling the particular plan.  Until the advent of
the National Plan ID, I suppose the NAIC company code of the payer could
appear directly on the insurance card as the "electronic" EDI address
for inquiries and claims.

But I don't see any way for the provider to use the 270 Loop 2100B
(Information Receiver Name) to convey his D-U-N-S to the payer for use
in returning the 271 Eligibility Response.  If the provider chose to
identify himself by D-U-N-S, how would the payer know which ID to use in
the response's ISA?  This might be what Chris Feahr wanted to know,
i.e., how to auto-discover the "return path" back to the provider?

Keep in mind that the provider's sender ID in the ISA should probably be
directly used only for TA1 and 997 acknowledgements;  there must be some
other means of figuring out the ID of the provider for application
responses since not only is the ISA long gone (discarded by the
translator), but prudence would dictate that the ID be derived from the
application data (or other data known to the payer) - rather than saving
the ISA sender ID.  This may not be a problem for the payer in the case
of in-network providers (where the payer would have the provider's
"preferred" EDI address - the D-U-N-S - on file). But a
non-participating provider has to have some means in the 270 transaction
to give the payer his preferred EDI ID.

The 837 Claim seems to have gone half-way in acknowledging this problem,
and provides a way for the provider (or his agent) to send the
"Electronic Transmitter Identification Number" (ETIN) to the payer in
the 1000A Submitter Name loop.  But there's no way to say whether that
code is a D-U-N-S, a Tax ID, or a HIN, or whatever - the 837 IG
unhelpfully says "Established by trading partner agreement."  Like the
270, the 837 does have a way for the provider of telling the payer his
FEIN (Tax ID) in the 2010AB Pay-to Provider loop;  but even if the
provider used the FEIN as his routing ID, there's no definitive way of
saying that it *is* the EDI ID (as opposed to just one more ID the
provider shares with the payer).

Can anyone help out here?  Am I the only one who thinks the HIPAA IGs
use IDs in kind of a "loosey-goosey" fashion?

William J. Kammerer
Novannet, LLC.
+1 (614) 487-0320


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