The X12N TG2 WG9 Patient Information 275 Transaction is also a Provider to Provider transaction that supports requests and responses from Provider to Provider for a variety of information. It can also be used from entity to entity requests and responses.
The following is the the Purpose and Scope of the Transaction - "This X12 Transaction Set contains the format and establishes the data contents of the Patient Information Transaction Set (275) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate individual patient information requests and patient information (either solicited or unsolicited) between separate health care entities in a variety of settings to be consistent with confidentiality and use requirements. Patient information consists of demographic, clinical, and other supporting data." Gale X12N TG2 WG9 Patient Information CoChair ----- Original Message ----- From: "William J. Kammerer" <[EMAIL PROTECTED]> To: "WEDi/SNIP ID & Routing" <[EMAIL PROTECTED]> Sent: Saturday, August 24, 2002 5:31 PM Subject: Provider to Provider Messaging What EDI transactions are exchanged between providers? I didn't notice any. Most are exchanged between providers and payers, with the possibility of the 837 and 269 exchanged between payers for COB stuff. Same thing for the NCPDP claims. You might have employer-sponsor to payer exchanges with the 834. And maybe some involving banks as intermediaries for the 835. But other than that? When you talk about provider to provider, are you all thinking of HL7? Even if there were to be any provider to provider EDI, the Healthcare CPP can handle this since it is completely symmetric. But unless there's something I'm missing, it doesn't seem there's going to be any EDI (unless it's HL7 clinical data) exchanged between providers - and thus no point in belaboring the point in the overview. William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ----- Original Message ----- From: "Christopher J. Feahr, OD" <[EMAIL PROTECTED]> To: "Bruce T LeGrand" <[EMAIL PROTECTED]>; "WEDI/SNIP Listserve" <[EMAIL PROTECTED]> Sent: Wednesday, 14 August, 2002 07:53 PM Subject: Re: Project Overview draft Bruce, Thanks for your comments. We definitely want to support provider-anyone messaging. If we have not made the provider-provider route clear enough in the "overview", however, maybe we can make a bit more of a point of that. Of course, Provider-Provider assumes that there are adequate, standard vocabularies and message structures in place to support it. I suspect that 90% of providers will be looking at CH connectivity for sending to payors and payor-mailbox model for the return path... a year from Oct... and that we are 2-3 years away from 2-way EDI at the provider-desktop level. -Chris At 10:04 AM 8/14/2002 -0400, Bruce T LeGrand wrote: I've been silent for a while, but this has caught my attention, again. Let's step back from the payer issue just a little. As a provider, I can probably address three or four direct connects in any state and deal with 80% plus of my claims volume. For the lower volume, infrequent connect payers, I can find a clearinghouse, probably no more than one or two, to address the remainder. I don't have an overwhelming burden in ensuring the efficient flow of claims, encounters, eligibility, status and other tasks. I have some issues dealing with reporting, but that's not a part of routing. Many vendors are actively developing solutions to remove these addressing burdens from the provider in the payment arena. Where my problem comes in is in the grand scheme of public health, where information I have related to a patient is effectively shared electronically with the potential thousands of specialists and others that will allow health care to be improved. I believe I understood that the objective was to reduce costs and improve health care. If I am looking for a good way to do automation, I don't think that provider to payer is the primary model. Look at provider to provider. A workable means of exchanging this type of data in a wholly automated fashion would indeed be a long term boon to the overall care of health. Christopher J. Feahr, OD http://visiondatastandard.org [EMAIL PROTECTED] Cell/Pager: 707-529-2268 discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
