Martin,
I'm very new to the industry, in that I am returning to it after 8 years of being away, so please excuse the simpleton inquiries. I do however possess 15+ years of IT Experience, so feel free to be technical in your response. Simpleton Inquiry: Regarding the "You must not give incentives of any kind to make partners use Inet Solutions". If one of the end in mind goals of Administration Simplification via Inet & EDI solutions is to lower the overall cost of health insurance and the provision of health services. Why would "government" prohibit a payor form incenting a provider? Taking a common sense approach there are only two ways to get a provider to use such a system and lower overall industry costs: 1. Payor or Government (Incentives) 2. Government Non-Compliance (Punishment) If you have insight into the reasoning, would you please pass it along? Sincerely, Todd Leeders -----Original Message----- From: Martin Scholl [mailto:[EMAIL PROTECTED]] Sent: Thursday, June 20, 2002 10:45 AM To: Scott Barley; [EMAIL PROTECTED] Subject: Re: Online Authorization / Referrals NO, You don't have to convert to X12. but..... 1.) you have to provide and process the same data content that the standard transaction has 2.) you still have to provide a standard system, even though your internet solution may be faster, more elegant and well appreciated. 3.) You must not give incentives of any kind to make your partners use the Internet solution over the standard one. Hope this helps Martin Scholl Scholl Consulting Group, Inc. 301-924-5537 Tel 301-570-0139 Fax [EMAIL PROTECTED] www.SchollConsulting.com ----- Original Message ----- From: "Scott Barley" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, June 20, 2002 11:17 AM Subject: Online Authorization / Referrals > Question: > > A payor is providing an internet based product to their providers for the > submission of referral/authorization requests directly into the payor's > system. The provider manually enters a request for an authorization within > the web application and the info is inserted directly into the database from > the web application. Since this is an extension to the payor's system > application and is not a system to system transaction, is their any need to > convert to ANSI 278 before placing into the system? > > > Thanks in advance for any info on this! > > Scott Barley >
