Hi Marcalee,
I have raised a couple questions within the routing group that William has 
asked me to bring to the "business issues" group... possibly in today's 
call:  Regarding payor identification at the transaction level, it seems 
that the HIPAA statutory requirements are forcing us toward a "national 
Plan ID" model rather than a "payor ID".  For the purpose of 
addressing/routing, however, it would seem preferable to ID the "payor" and 
then to utilize the situational SBR03 and 04 segments (plan number and plan 
name) to identify the particular "plan" or line of business the claim is 
being directed to? Burying the plan's identification with the payor's ID 
(which will necessarily create "multiple identities" for all payors with 
multiple lines of business) seems to be muddying the waters for us in the 
context of the provider's addressing/routing problems... particularly the 
"small" provider trying to send something directly to a payor.

-Chris


At 10:06 PM 2/18/02 -0800, Marcallee Jackson wrote:
>We will have our regularly scheduled call:
>
>  Dial In: 703-736-7290 PIN 1315330
>
>Agenda:
>
>Issues Database (IDB) preliminary recommendations
>
>White paper updates:
>         Update Routing (Peter or William)
>         Restarting the Code Set Resolution SIG (Zon)
>         Review suggestion for TPA paper (Marcallee)
>         Contingency Planning (Lin)
>         Suggestions for new papers
>
>Update on March's conference/Need volunteer panelists
>
>Please join us on the call!
>
>
>Marcallee Jackson
>Long Beach, CA
>562-438-6613
>
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Christopher J. Feahr, OD
http://visiondatastandard.org
[EMAIL PROTECTED]
Cell/Pager: 707-529-2268        


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