William,
Some of our "preferred ID" discussions seem to be flipping back and forth
between the preferred ID-key for the "CPP Registry" and the ID that the
message receiver would prefer to have in the ISA... one of the items that
would be enumerated in the CPP Registry record.
If there were several healthcare CPP registry services available (perhaps
WEDI would agree to maintain one for HIPAA covered entities), I would think
that a good key for an organization's CPP record would be the FEIN.
Regarding the discovery of the preferred "return path" to the small
provider, a payor could take the provider's FEIN from the individual
transaction (a 270, for example) and look up that provider's CPP... and
determine [for example] that he likes all his 271s sent to a CH maintained
by his OMS vendor, and his 835s sent to his bank.
I know I'm supposed to be researching the innards of the CPP being proposed
by OASIS (haven't gotten to it yet!), but for our purposes it would
certainly need to contain the preferred ISA receiver info for each of the
HIPAA transactions, as receivers may want certain transactions sent to
different EDI addresses.
Is this the general scenario you have in mind, William?
-Chris
At 10:20 AM 3/29/02 -0500, William J. Kammerer wrote:
>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
Christopher J. Feahr, OD
http://visiondatastandard.org
[EMAIL PROTECTED]
Cell/Pager: 707-529-2268
