Stanley,
The question regarding "additional information" came up at our last X12N meeting in the Eligibility Work Group. I'm not sure I fully agree with your answer. It seems to me, that if additional information is provided on the transaction that would be of value to the provider, then it should also be on the 271 transaction or else it makes the DDE solution more desirable to use than the 270/271, which is not permitted by Final Rules for Transactions Section 162.925(a)(1-4). If the 271 transaction can't support the information, then I would suggest that this addtional information should be set up as a distinct inquire, separate from the eligibility inquiry. If the 271 has a short coming in providing necessary information, then the health plan should bring this to the attention of the X12N SDO via the DSMO process or they should attend the X12N conference and Eligibility Work Group and raise the concern there. Don Bechtel "Stanley Nachimson" <[EMAIL PROTECTED]> on 10/09/2001 10:45:52 AM To: <[EMAIL PROTECTED]>, <[EMAIL PROTECTED]> cc: Subject: RE: White Paper - Impact on DDE Services There are two questions being discussed here. Regarding the "additional information" we have considered that any DDE system can provide additional information on additional screens (or using links if it is a Web based system). However, providers can not be required to access or accept the additional information. Regarding the need to accept a 270 and respond to a 271, that is a requirement of the regulation. A web based DDE system can be offerred as an option, but requirment is that the regular EDI 270/271 EDI transaction must be supported. Stanley Nachimson Office of Information Services, CMS 410-786-6153 >>> "Neumeister, Tammy" <[EMAIL PROTECTED]> 10/09/01 09:40AM >>> 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. ------------------------------------------------------------------------------- This message and any included attachments are from Siemens Medical Solutions Health Services Corporation and are intended only for the addressee(s). The information contained herein may include trade secrets or privileged or otherwise confidential information. Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you received this message in error, or have reason to believe you are not authorized to receive it, please promptly delete this message and notify the sender by e-mail with a copy to [EMAIL PROTECTED] Thank you ********************************************************************** 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.
