What I have read/heard agrees with Andy's comment. If the provider chooses an EDI transaction then the receiving entity must be able to accept it and process a response in compliance to HIPAA. The only caveat is for the EDI transaction to relate to the business of the receiving entity. An insurance carrier would not be out of compliance if they rejected a manufacturing EDI transaction.
Peg DeForge 636-2141, MA3H -----Original Message----- From: Fontalbert, Andy [mailto:[EMAIL PROTECTED]] Sent: Tuesday, October 09, 2001 9:46 AM To: 'Neumeister, Tammy'; [EMAIL PROTECTED] Subject: RE: White Paper - Impact on DDE Services It is my understanding that if a "270" transaction is chosen by a provider then it must be accepted by the entity, and returned in the proper manner. This would be required whether or not you provide web access to this information. Andy Fontalbert HIPAA Analyst ACS State Healthcare, Inc. [EMAIL PROTECTED] -----Original Message----- From: Neumeister, Tammy [mailto:[EMAIL PROTECTED]] Sent: Tuesday, October 09, 2001 9:40 AM To: [EMAIL PROTECTED] Subject: RE: White Paper - Impact on DDE Services This question has raised another question at our organization. We are considering purchasing a product from our payor software vendor that would allow web access to providers for eligibility inquiry, referrals, and claim status inquiries. Is this sufficient to comply with the HIPAA requirements for electronic capabilities for these transactions or must we also be able to accept and return an EDI 'batch' transaction for providers? Tammy Neumeister SAS Programmer MercyCare Insurance Company PO Box 2770 Janesville, WI 53547-2770 800-752-3431 X 3068 Direct 608-758-7725 Fax 608-752-3751 [EMAIL PROTECTED] > -----Original Message----- > From: Karen LaJaunie [SMTP:[EMAIL PROTECTED]] > Sent: Monday, October 08, 2001 3:44 PM > To: [EMAIL PROTECTED] > Subject: White Paper - Impact on DDE Services > > I have a question regarding the 'Impact on DDE Services' White Paper - > 8.15 No Incentives for Using DDE. > > Is it considered an 'incentive' if more information is returned via a Web > Site transaction than from an EDI Transaction? > > For example, if a provider inquires about a Member's Eligibility via our > Web Site, our Web Site has the ability to return more information > regarding the eligibility of the member than our EDI process which is > controlled by a vendor system. Is this considered 'incentive' for the > provider to use our Web Site rather than submitting the 270 via EDI? > > Any input regarding this issue is appreciated. > > Thanks! > > > > Karen L. LaJaunie > Senior Project Consultant > Blue Cross Blue Shield of Kansas City > Phone: (816) 395-2635 > Fax: (816) 395-2605 > > > ********************************************************************** > 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. ********************************************************************** 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.
