Major payers who are farther along in their preparations will not necessarily want to delay. Or, their project plan for implementation (required for the application to delay) could call for a phase-in of the standards - they may want to stay "on schedule" with one or several large providers with whom they have a good relationship and with whom they want to start working directly rather than through a clearinghouse...or, they may want to add support for a new transaction (Claim Status? 278?) as part of an administrative cost-cutting plan, and so may want to stay "on-schedule" with providers or clearinghouses who are also "on-schedule"...
Individual "transaction senders" sharing with their big partner "transaction receivers" information re: how they're addressing the delay option could give logic to the whole thing...provide for good planning and execution... Cynthia Korman ----- Original Message ----- From: "Scott Sallyards" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, January 15, 2002 9:28 AM Subject: Re: Transaction Delay Question > Can anyone tell me if they think that this issue is industry wide, now that > organizations can apply for a delay? Will the payors accommodate the needs > of the providers (even though it is the providers responsibility). I am > working with some providers and we trying to determine when will be the best > time to flip the (transaction) switch. > > Scott > > ----- Original Message ----- > From: Christopher J. Feahr, OD <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Sunday, January 13, 2002 10:12 AM > Subject: Re: Transaction Delay Question > > > > Until the deadline (any payor's deadline), that particular payor can > > legally refuse to conduct a TX as standard even if the provider requests > > that it do so. It certainly doesn't HAVE to refuse, but it can. So the > > provider's options are exactly the same as they are today... figure out > how > > to create the format that the payor WILL accept directly or go through a > > clearinghouse. The costs for both options would have to be borne by the > > provider... right up until the Payor's compliance deadline. After that, > if > > that payor is still not ready and still requires a CH to translate std. to > > proprietary, then the PAYOR will have to pay for the provider's > translation > > service. > > > > (keeping track of this looks like a major pain for the CH) > > -Chris > > > > At 08:22 PM 1/9/02 -0500, Paul Costello wrote: > > > > > > >What are the business implications of the following scenario that occurs > > >on October 17, 2002: > > > > > >I am a health plan and I already filed for the extension (I only have the > > >capability to accept non-standard formats). > > > > > >One of my trading partners (Provider ABC) purchased a whole new health > > >information system that is 100% HIPAA compliant and only has the ability > > >to conduct electronic transactions in the HIPAA standard format. > > > > > >Since I (as the health plan that filed for the extension) can not accept > > >standard transactions yet, and my trading partner (who just purchased a > > >HIPAA-compliant HIS) can only send standard transactions, what happens? > > > > > >Am I, as the health plan who can not accept standard transactions, > > >responsible for routing those transactions through a clearinghouse, or is > > >it the responsibility of the provider? What other solutions exist? > > > > > >It seems like this situation, and many variations like it, will become > > >problematic after October 16, 2002. > > > > > >Any thoughts are appreciated. > > > > > >Thanks, > > >Paul > > > > > >********************************************************************** > > >To be removed from this list, go to: > > >http://snip.wedi.org/unsubscribe.cfm?listsiness > > >and enter your email address. > > > > Christopher J. Feahr, OD > > http://visiondatastandard.org > > [EMAIL PROTECTED] > > Cell/Pager: 707-529-2268 > > > > > > ********************************************************************** > > To be removed from this list, go to: > http://snip.wedi.org/unsubscribe.cfm?list=business > > and enter your email address. > > > > > > > ********************************************************************** > To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business > and enter your email address. > ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address.
