RosettaNet and other initiatives have chosen to identify every partner
using the same ID domain, such as D-U-N-S. This does make things
slightly simpler, in that no one has to remember what kind of identifier
this 9 digit number is - it's always a D-U-N-S!
I don't really think it's necessary, though, to force all players to
identify themselves using IDs from the same domain. Christopher J.
Feahr, OD, may prefer to always identify himself with his Federal Tax
ID - it's incumbent then for all his partners (payers and lens
manufacturers) to address him with his TIN in the ISA. But, another
provider, like Children's Hospital, may choose to use its HIN (Health
Industry Number) for procurement transactions, but the D-U-N-S when
exchanging administrative HIPAA standard transactions with payers. On
the other hand, insurance companies might choose to be identified with
their NAIC company codes.
Most entities have at least one ID from multiple domains - e.g.,
Christopher J. Feahr, OD most certainly has both a D-U-N-S and a TIN.
Aetna has not only a D-U-N-S and a TIN, but also a NAIC company code.
Some outfits even have more than one ID from the same domain - it's easy
to have multiple D-U-N-S numbers due to mergers or acquisitions. Even
though the Federal Tax ID number doesn't have the same weaknesses as the
Socialist Security number used for individuals - it's almost never used
for authentication, but only for identification - some entities still
may prefer not to use it to identify themselves, leaving them to favor,
say, the D-U-N-S.
Since an exchange of HIPAA standard transactions is initiated by the
provider, it's easy enough for the provider to obtain the payer's EDI
ID; for example, the NAIC company code of the payer could appear
directly on the patient's insurance card as the "electronic" EDI address
for inquiries and claims. From there, it's clear sailing to locate the
payer's CPP based on the NAIC.
But as I ruminated on Tuesday, in "More Stuff and Questions on Routing
Identifiers," how would the payer know how to address the provider it's
responding to? There doesn't seem to be any clear way in the 837 or 270
for the provider to tell the payer which ID and domain to use for
addressing transactions back to him. Always using the TIN for ISA IDs
might solve this problem, but forcing an inflexible naming system on all
partners ("You must always use the TIN") might be less desirable than
figuring out some way for the 837 or 270 to communicate the preferred
EDI ID (and domain) for responses.
I'll make one concession, though: mandating use of a single domain
(e.g., the TIN or D-U-N-S) to identify all parties (e.g., providers,
payers, repricers, TPAs, CHs) on the ISA would be far preferable to the
situation we have today with a surfeit of payer-assigned provider IDs.
William J. Kammerer
Novannet, LLC.
+1 (614) 487-0320
----- Original Message -----
From: "Christopher J. Feahr, OD" <[EMAIL PROTECTED]>
To: "William J. Kammerer" <[EMAIL PROTECTED]>; "WEDi/SNIP ID &
Routing" <[EMAIL PROTECTED]>
Sent: Thursday, 28 March, 2002 05:39 PM
Subject: Re: What's the focus?
if I understand this thread, we MUST choose one of the legal ISA
identifiers as a KEY to this (yet-to-be-defined) record that explains
all of the 'collaboration" details... including other ISA identifiers
that might be acceptable?
If so, I would vote for the Fed. Tax ID# for the registry key. As I look
down this list, the FTIN seems to be the only one reliably there 100% of
the time and one that virtually every business will know (about itself)
and have no qualms (and violate no user agreements) disclosing to "the
world".
-Chris
01 Duns (Dun & Bradstreet)
14 Duns Plus Suffix
20 Health Industry Number (HIN)
27 Carrier Identification Number as assigned by Health Care Financing
Administration (HCFA)
28 Fiscal Intermediary Identification Number as assigned by Health Care
Financing Administration (HCFA)
29 Medicare Provider and Supplier Identification Number as assigned by
Health Care Financing Administration (HCFA)
30 U.S. Federal Tax Identification Number
33 National Association of Insurance Commissioners Company Code (NAIC)
ZZ Mutually Defined
At 04:46 PM 3/28/02 -0500, William J. Kammerer wrote:
>as always, "[our] primary problem to solve is getting
>some consistent way of identifying providers as EDI participants - and
>getting everyone (including payers) to use that same ID for looking up
>providers' EDI addresses (inter alia) in the Healthcare registry."
Christopher J. Feahr, OD
http://visiondatastandard.org
[EMAIL PROTECTED]
Cell/Pager: 707-529-2268
