The decision regarding whether to accept a transaction that the receiver believes does not comply is a business decision of the entity receiving such a transaction. The decision is reached based on several factors included in any organization's normal risk analysis activities which result in business policies and business rules, which can then (in some cases) be enforced through program logic in automated business systems.
Rachel Foerster -----Original Message----- From: Julie Thompson [mailto:[EMAIL PROTECTED]] Sent: Wednesday, December 04, 2002 11:32 AM To: WEDI SNIP Testing Subworkgroup List Subject: RE: Defining a health care claim within the context of the 837 implementation guide HHS is the group to answer the question of whether to accept a non HIPAA compliant transactions in production (X12 alone is NOT compliant). I have spoken with Stanley Nachimson and non compliant production transactions are subject to fine for both the transmitting and the receiving partners. There was an HHS FAQ I am unable to find the FAQ stating the above, but here are some other helpful related HHS FAQs. To submit a questions for publication go to: http://aspe.hhs.gov/admnsimp/bannertx.htm HERE ARE SOME VERY HELPFUIL HHS FAQs: HHS FAQ: Question How would someone file a complaint against a covered entity? Answer CMS will develop a web-based complaint management process, and will provide information on this process as part of our HIPAA outreach activities. Question What will the enforcement process look like? Answer The enforcement process for HIPAA transactions and code sets (and for security and standard identifiers when those are adopted) will be primarily complaint-driven. Upon receipt of a complaint, CMS would notify the provider of the complaint, and the provider would have the opportunity to demonstrate compliance, or to submit a corrective action plan. If the provider does neither, CMS will have the discretion to impose penalties. --- The WEDI SNIP listserv to which you are subscribed is not moderated. The 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/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-testing as: [email protected] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
