Chris, I will use a healthcare example.
If I am going to a cardiologist and he recommends a heart transplant, that he will perform himself, to take care of a heart condition, I probably want to have a second opinion from another specialist. By going to a different cardiologist, one that will NOT have an involvement in the procedure, I am getting some assurance of no undue bias in the opinion. Will they agree on my need for a transplant? Maybe, may be not. If there is a disagreement, does that mean that the disagreement is because the first one had an undue bias or was not expert enough? Probably not, as there are many different approaches to the treatment of heart conditions. Does that sound like the HIPAA implementation guides? Yes, there are many different interpretations of the more obscure aspects of the guides. Would I go to a podiatrist in order to get a second opinion for a heart transplant? If I want the second opinion to be relevant, I should go to a specialist that has at least as much relevant experience, and probably more experience than the one that is going to operate on me. That would be another cardiologist. Is the second opinion going to be free? Guess... Should I get the second opinion from a not-for-profit institution? Not unless they have great cardiologists. If I get the second opinion from a cardiologist from a not-for-profit institution, will it be a better opinion than if I get it from a cardiologist in private practice? I doubt it makes any difference. Why do I need a second opinion? I don't really need a second opinion, but it is my choice before anybody touches my pump. Will the second opinion change or improve the outcome of the operation? Probably not, unless the second opinion has recommended some specific issues to be taken into consideration by the surgeon, and the surgeon follows those recommendations. Does the fact that I am paying the second surgeon to get a second opinion make that surgeon a "1st or 2nd party" ? As long as it is clear that the second surgeon is only involved in the second opinion and will not be providing assistance in the surgery or the post-op care, the second surgeon is a third party to the primary relationship. The primary relationship is between my surgeon and myself. So, if a vendor sells you software and certifies your transactions produced by that same software to prove that the software is good, they are not a 3rd party. If a vendor is trying to certify and fail your transactions so they can sell you new software or remediation services, they are not a third party. But if a vendor uses, or helps you use, somebody else's test system to test your transactions, and, based on the results of an independent testing, the vendor remediates your problems, then the vendor and you are the 1st/2nd parties and the independent testing is the 3rd party. But it has to be truly independent, without interest in selling you software or services other than in the testing capacity, and without interest in the remediation or bias in the test results being slanted toward passing or failing the test. Now, lets say that you contract directly with a test vendor, and you are doing your own remediation. In that case, for testing purposes, your dealing with the test vendor is as 1st/2nd party. As such, you are the test vendor's customer for testing purposes. Certainly the test vendor has an incentive in selling you the test product or service. The test vendor is not a 3rd party to this relationship. But the objective of this relationship is, I hope, to help you remediate your system. The objective is not to just test for the sake of testing. The objective is not just the experience of testing, but the remediation that may ensue if the testing uncovers something. Another healthcare example. When I go to my annual physical exam, I do not do it for the pleasure of being poked and probed. I can certainly do without that particular pleasure, if you know what I mean. I do it so if there is a problem it can be detected early and remediated before it grows into a bigger problem that affects the rest of my system. And, I don't go to a cardiologist to get my physical, but if the physical uncovers a cardiac problem, I will then go to the cardiologist to find and pursue the appropriate corrective action. But if the physical uncovers the fact that I am overweight, and I can fix that myself with diet and exercise, there are no other parties involved. In that case, all I needed was the physical exam, and I can take care of the rest. And, it is still my choice as to how much I am going to exercise and what will I eat. If I choose to not make changes, I can't blame it on the results of the annual physical not being helpful. It diagnosed a weight problem and I chose to do nothing about it. My choice. Also, the fact that the annual physical showed that I am in good health, should not be interpreted as being immune from catching the flu the following week, or being run over by the train, or actually having cancer or other health problem. So, if the annual physical does not take care of my problems and does not guarantee that I will be free from illness for the next 12 months, why do I do it? Am I wasting my money and time? If the annual physical can identify something that would not be identified otherwise, and correcting that problem early can improve my future quality of life, it is well worth it for me. I know for a fact that other people will make different choices and will only go to the doctor only after they are sick. That is their choice. I am not to judge them for their personal choices. I hope they don't put ads in the newspaper listing me by name as a person that wastes his money by having annual medical exams. And I hope my doctor is not publicly lynched by offering a service that cannot guarantee perfect health for the lifetime of those that buy the service, and having the audacity to charge for such a "hoax" of a practice. OK, I will stop here, since I am starting to drift off the topic. Does this make sense? Kepa On Friday 20 December 2002 08:01 am, Chris Brancato wrote: > Bill/John, > Is it fair to say then that independent 3rd party should be defined as one > without commercial profit motive? Is that what I'm reading? I, too am > getting lost. As we know, non-profit does not mean you don't make a profit. > > Chris Brancato > > -----Original Message----- > From: William J. Kammerer [mailto:[EMAIL PROTECTED]] > Sent: Friday, December 20, 2002 9:52 AM > To: WEDI SNIP Testing Subworkgroup List > Subject: Re: Who's on Third? > > John, you're losing me. There would a conflict only if a "3rd-Party" > tester were selling translators, practice management or adjudication > systems or whatever - or offering remediation services - the very things > supposedly being tested. None of Claredi (the Lord Voldemort of HIPAA > Validation - "He-Who-Must-Not-Be-Named"), Foresight and Edifecs sell the > types of software they purport to test. Thus, they can each credibly > call themselves an "independent 3rd-party," whether they're selling > hosted testing services or desktop validation software. > > William J. Kammerer > Novannet, LLC. > Columbus, US-OH 43221-3859 > +1 (614) 487-0320 > > ----- Original Message ----- > From: "John Singer" <[EMAIL PROTECTED]> > To: "WEDI SNIP Testing Subworkgroup List" <[EMAIL PROTECTED]> > Sent: Thursday, 19 December, 2002 12:42 PM > Subject: Re: Who's on Third? > > William, > > You are right. In most of the US the certification is 2nd party as > currently defined as communities are naming the certifiers and demanding > to use them. My point was they are not true 3rd parties, nor independent > because of the underlying motivation of being able to make a software > sale to the client instead of just being in the business of being an > independent certifier with no monetary enticement on the backend. > > John Singer > Duluth, MN. > -- > > ----- Original Message ----- > From: "William J. Kammerer" <[EMAIL PROTECTED]> > To: "WEDI SNIP Testing Subworkgroup List" <[EMAIL PROTECTED]> > Sent: Thursday, 19 December, 2002 12:04 PM > Subject: Who's on Third? > > The 1st and 2nd parties would be the covered entities testing standard > transactions. The testing or certification service is a "3rd party." > No certification or testing service is self-appointed: at least one of > the parties (the "1st" party, usually the payer) has selected (or > "appointed") the vendor to serve as a proxy for itself in order to vet > trading partners. > > William J. Kammerer > Novannet, LLC. > Columbus, US-OH 43221-3859 > +1 (614) 487-0320 > > ----- Original Message ----- > From: "John Singer" <[EMAIL PROTECTED]> > To: "WEDI SNIP Testing Subworkgroup List" <[EMAIL PROTECTED]> > Sent: Thursday, 19 December, 2002 11:26 AM > Subject: Re: NCQA Certifies Compliance SNIP Comes Up Short > > Marcallee, > > One of the other major problems is WEDI definition of "third party". > Third parties as defined currently is incorrect, no such thing as a > self-appointed third party, that is called 1st party testing and also > how can you be considered "independent" when you sell software as a > vendor? You are not independent you are trying to sell your products... > > Third party certifier have an organization watching over their shoulder! --- 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. 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