8/12/02 As idealistic as it surely is, and as jaded as I became about "paperless business absent a TPA" in the early EDI days, I am not so sure a CPP for the healthcare industry is pie in the sky for one reason: volume.
Unsolicited and TPA-less Electronic Business never took off for one reason: every player used his own implementation. But even the 364-kilogram simians like Walmart, Ford Motor and Medicare were only mandating implementations to at most two or three thousand partners. Regardless of what one thinks of the HIPAA mandates, we will now have some 360,000 possible partners using the same implementation rules. Surely if the underlying business transactions can be put into a standard implementation, so then can the communications and routing parameters - which are far, far, simpler. Biggest obstacle? Hands down, it's inertia: the tendency of anything to remain in its current state; and the bigger the object (i.e., entities the size of payers), the greater the inertial forces. FWIW, I am fnally getting back to an analysis of the CPP, and so far - viewed as an applications developer - it looks as though almost all the info I would need to create applications software for Suzy Provider is pretty much in place. For these 360,000 Suzys, that means... "I got this patient's insurance card. I want to send his payer a claim. I only want to enter this one magic number (e.g., UPIN, NAIC, whatever) from the card and let my software handle all that ID and routing stuff." If it isn't this easy, ten bucks says Suzy never even makes the effort to 'go electronic' - she just puts a HCFA-1500 form in the typewriter and reaches for a postage stamp. (You younger folks can find 'typewriter' in any good dictionary). Now the software may come back and say, "Sorry, Suzy, but that payer is not yet accepting electronic claims, so put a HCFA-1500 form in the typewriter and reach for a postage stamp" - but if *one entry* by Suzy can tell her this, she will make that one entry each time. And maintenance? For the payers, maintaining their own CPP entry is just plain smart business - if you assume processing claims electronically is less expensive than processing paper claims. Michael Mattias Tal Systems, Inc. Racine WI [EMAIL PROTECTED] ----- Original Message ----- From: "Martin Scholl" <[EMAIL PROTECTED]> To: "William J. Kammerer" <[EMAIL PROTECTED]>; "WEDi/SNIP ID & Routing" <[EMAIL PROTECTED]> Sent: Tuesday, August 06, 2002 11:15 AM Subject: RE: Project Overview draft > > My problem with the CPP is that it is a pie in sky. Yes, I can see that it > is cute to have an XML exchange that returns all the parameters for a > trading partner relationship, but I can as well call and have them fax me or > email me a fact sheet on trading relationships. I don't believe there will > be automated and instant trading partner relationships without testing and > certification for a while. > > I would like to hear which modes of routing others in this group are using > or planning to use. > 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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
