Todd:
Your hypothetical scenario assumes the payer has an arrangement whereby
all 835s (remittances) are submitted through CHB. Therefore, I suppose,
the payer should return the 835 through CHB. The route whence the 837-I
arrived is irrelevant, and all knowledge of the original claim's path is
I guess you could say my e-mail server is an "open portal." You never
know what's going to come across; see below. Now even without examining
the headers (which probably aren't forged, otherwise the spaminator
would've discarded the message), I can tell I needn't bother with this
e-mail. But it
In my opinion, we have to separate two things here. There is today - and
the desired future.
Today, an open door can not work. There ARE security issues and
connectivity issues and identification issues and contract issues and
validation issues and - well, you get the point. We can not ignore
I hate to say this, but the 835 will be a totally different beast.
The provider CAN say that they want the 835 to be delivered to their bank,
or a different clearinghouse.
The 835 route can be different than the claim route - in fact, there does
not have to BE a claim route - paper claims go on
I don't think the 1000A (Submitter Name) and 1000B (Receiver Name)
"audit trail" in the 837 are all that important. Besides, the other
transactions (like the 270/271, 276/277 and 835) don't have an analog of
this "audit trail." Based on previous observations, though, it's
probably the usual cas
I agree, up to a point. But I still say that a form of pre-qualification
must exist, at the trading partner level. The last thing I want to do,
as a payer, is disclose eligibility data about one of my customers to
someone not eligible to receive said data, also a clear violation of the
only part o
I'd have to turn the question back around. How can Wal-Mart, not mandated to
support federally required security and privacy, require a closed environment
and the Health Care industry not?
--( Forwarded letter 1 follows )
Date: Thu, 30 May 2002 15:30:18 -0500
To
Yes, certainly, the provider CAN say that they want the 835 to be
delivered to their bank, or a different clearinghouse. But what would
the payer do if the clearinghouse or bank came back and said:
"Whoa, hold on big fella! Before just anyone sends 835s into
us, we gotta make sure you're
William, you wrote:
The ISA sender and receiver IDs must be valid identifiers from a limited set
of domains, e.g., HIBCC HIN, NAIC Company Code, Dun & Bradstreet D-U-N-S,
IRS Tax ID (FEIN), etc.
It is my impression that when you choose the qulifier "ZZ" you can put
anything in there. Whatever you
And the gander does that - to the extent required now - we do not send 835s
to a clearinghouse or bank until the provider requests it and the
clearinghouse or bank verifies that they can receive 835s.
But - on the more inflamatory aspects, the business relationship that
exists is between the pro
There is at least one network that uses ZZ in ISA qualifiers (mind you, this
does not represent advocacy or condoning on my part--it's just an
observation): When sending X12 interchanges via Advantis (IBM, right?),
when you specify ZZ as the qualifier, the receiver identifier, specially
formatted
William,
Well said!
Rachel
-Original Message-
From: William J. Kammerer [mailto:[EMAIL PROTECTED]]
Sent: Thursday, May 30, 2002 6:15 PM
To: WEDi/SNIP ID & Routing
Subject: Open Portals and "Blind Trust"
Clearinghouses could have taken care of trust issues between payers and
"unknown"
Bob,
Thanks for (attempting) to get the focus back. I've said this in so many
different ways over the last several months that I've run out of words.
The path is to
1. document what today's "current state" is
2. decide what you want the "future state" to be
3. chart a transition plan to get
Bruce,
Easythe feds haven't put any federal laws in place requiring Wal*Mart to
do something different. Thus, Wal*Mart is free to determine its own
electronic commerce strategy and requirements as it chooses for each
market/geographic region of the world it does business in.
Furthermore, kee
Bruce,
I agree that you most certainly don't want to respond to an eligbility
inquiry without first authenticaing the information receiver.
But, this has nothing at all to do with taking the EDI interchange into your
electronic mailroom. There's a multi-step process here with various levels
of v
I guess the difference, in our form of looking at transactions, is that I have
a completely competent computer "opening the envelope", with every known
trading partner in it's databases. Instantaneous determination, rather than
ending up in a waste basket because no one knew who to do what for.
--
It wouldn't be that difficult to have a dedicated, stand alone server,
outside any firewall that could accept unsolicited EDI transactions.
The server could be 'unloaded' and the transactions probably manually
reviewed.
P.S. People are doubling up listserv emails by putting the listserv name
in t
Its been very interesting catching up on all of the "routing" messages over
the last week regarding this subject. What seems to have been missed, but
Rachel caught, is that the CPP is simply an instrument to create the CPA -
which is the electronic equivalent of the trading partner agreement.
I
Martin Scholl's impression that the HIPAA IGs allow you to choose the
ISA qualifier "ZZ" so you can put "anything in there" is correct. As
far as I know, the guides have not changed since I last saw them.
And we can accommodate the ZZ qualifier in our CPP Electronic Partner
Profile: the receiver
19 matches
Mail list logo
