Hey, Rob! We miss you around here.
While option 5 sounds great, we're settling in
somewhere between 1 and 2. This whole issue of receiving data in "Not Used"
elements is complicating our compliance picture and will likely drive us to
do everything related to syntax in the translator with little or no
pre-production testing (And we call this Administrative Simplification?).
Test and Prod files will all receive the same scrutiny. When the vendor
starts sending us real data instead of the stuff they crafted so carefully
during testing, we won't have to jump through so many hoops.
How are things in WI?
Martin A. Morrison
Project Management Consultant
HIPAA <http://aspe.os.dhhs.gov/admnsimp/>
Implementation/Coordination
Blue Shield of California
<http://www.blueshieldca.com/>
80 Blue Ravine Rd., Ste 150
Folsom, Ca 95630
(916) 350-8808
[EMAIL PROTECTED]
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-----Original Message-----
From: Robert Barclay
[mailto:[EMAIL PROTECTED]]
Sent: Wednesday, October 03, 2001 10:54 AM
To: [EMAIL PROTECTED]
Subject: Compliance Testing
Approaches
I am interesting in how other payers are
approaching trading partner compliance testing. We are reviewing our
options and wonder what others are planning. The approaches under review
are:
1. Do passive compliance testing. We are
building translation processes around the HIPAA standards. Therefore, any
trading partner's test file that translates successfully is likely
compliant.
2. Do active compliance testing in-house.
We could setup a separate testing process using the capabilities of our
translator or separate EDI testing software. Once the file passed our
compliance testing we could test it for business rules and adjudication
results in our EDI test environment.
3. Contract with a testing service to
perform the HIPAA compliance testing (ENHAC, Claredi, or Foresight.) We
would not run the trading partner's file into our EDI test environment until
the testing service OKed it.
4. Require our trading partners to obtain
compliance certification before they can test with us. This could be a
testing service's or another payer's acceptance.
5. Don't worry about compliance testing.
This is a submitter responsibility and the Medicare payers are starting
testing soon. Let the Medicare fiscal intermediaries spend the time and
money to educate the providers.
Robert Barclay
EDS - Wisconsin Medicaid HIPAA Team
[EMAIL PROTECTED]
(608) 221-4746 x3323
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