Robert, I think you have asked a broad question that could be best answered by it depends. My experience with state Medicaid programs is that they bend over backwards to help providers get claims to them. Medicaid operates in more of a political arena and they are sensitive to that. A private payor may want to negotiate 'certification' and who pays the cost. This negotiation might also involve communication costs such as the use of Value Added Networks (VAN's). It will be interesting to see even if a payor were to cover the costs of 'certification' testing how may providers would do it. It still takes an effort to go through testing that some providers may not feel is necessary. Regards, Dave Frenkel EC/EDI Consultant
----- Original Message ----- From: Robert Barclay <[EMAIL PROTECTED]> To: > <<[EMAIL PROTECTED]> Cc: Craig Steele <[EMAIL PROTECTED]> Sent: Wednesday, October 31, 2001 9:45 AM Subject: Who Pays for Compliance Testing? Who should pay for compliance testing, the transaction sender or the transaction receiver? This assumes, of course, that a third party is performing the testing. Both parties have legal and practical interests in insuring the exchanged transactions are compliant. It would appear the first level of responsibility lies with the creator of the file. They must create a compliant transaction. The receiver of the transaction just needs to identify compliance and reject it if non-compliant. In practice, however, payers in the claims world have a vested interest in getting clean test 837 transactions. Large payers have hundreds or thousands of claims trading partners to test by October 16. Compliance testing should clean up all but exchange management and adjudication optimization testing issues for payers. So, once more who should pay for compliance testing? Kepa, or other smart people, would you care to comment? Robert Barclay EDS - Wisconsin Medicaid HIPAA Team [EMAIL PROTECTED] (608) 221-4746 x3323 ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request.
