You mention Benefit Enrollment and Maintenance Stuff, which is probably the 834, but you don't indicate what business process. You also don't indicate what the 835 is being used for.
1. There are business processes supported by the 834 and 835 that are not necessarily the business processes mandated under HIPAA. Consequently, whatever your client is doing may not have to be HIPAA transaction and code set compliant, but I doubt that. There are no government regulations or approvals required for EDI providers or EDI software. I don't know what you mean by the "generic implementation guide for 834/835." 2. Look here for the BCBSMA 835 companion guide: http://204.250.122.62/healthwire/documents/8352.3.pdf 3. Communications are not specified by the HIPAA Transaction and Code Set rules, just the format and content. The Privacy and Security rules should be consulted. 4. Yes, 997's are usually sent, but not required. 5. I believe that you will find some testing information in the PDF mentioned above. Steve Bass Washington Publishing Company http://www.wpc-edi.com ________________________________ From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Vijay Thomas Sent: Thursday, December 21, 2006 10:38 AM To: [email protected] Subject: [EDI-L] General HIPAA and Blue Cross Question Hi Folks, We are a Supply chain consulting company headquartered in Toronto,Canada and we primarily did EDI for Retail, distribution and automotive companies (until now). A few days back one of our customers who has an office in Boston had to send some Benefit Enrollment and Maintenance Stuff 834 & 835, to their Carrier - Blue Cross Blue shield. We were asked to do it as we are their outsourced EDI provider for retail EDI - however we were never in this space so I have a few basic questions 1) Is this HIPAA stuff. Is there any Government regulations or any kind of approvals required for EDI providers or EDI software to do 834/835. Is there somebody that ratifies that the EDI is HIPAA complaint - I have the generic implementation guide for 834/835. 2) How do you get the EDI Guidelines for Carriers like Blue Cross - tried speaking to customer service but did not get far. In fact don't know if I should contact Blue Cross MA or is there a Blue Cross EDI group that handles EDI for all Blue Cross. 3) Do 834/835 transactions use VANs or do they use any other P2P communication protocols like AS2, FTP, SFTP etc 4) Do the carriers send 997's like in retail EDI. 5) What is the normal testing process for these carriers ( get a feeling these guys are the Wal-Marts of the HIPAA world) Any information would be highly appreciated and guess what ..anytime any of you are in Toronto - we will make sure that Dinner will be on us. Please also reply to the group as I am sure there are other people like me who could also get educated on this stuff. Merry Christmas and Happy Holidays! Sincerely, Vijay Thomas B.Eng , M.B.A Principal Consultant and Partner Tangentia Inc 211,Consumers Road Suite 203 Toronto, ON, M2J4GB Tel- 416-238-7515 ext 111 Cell- 416-899-7194 email- <mailto:[EMAIL PROTECTED] <mailto:vijay%40tangentia.com> > [EMAIL PROTECTED] <mailto:vijay%40tangentia.com> web- <http://www.tangentia.com <http://www.tangentia.com> > www.tangentia.com [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] ... Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Job postings are welcome, but for job postings or requests for work: <JOBS> IS REQUIRED in the subject line as a prefix. Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/EDI-L/ <*> Your email settings: Individual Email | Traditional <*> To change settings online go to: http://groups.yahoo.com/group/EDI-L/join (Yahoo! ID required) <*> To change settings via email: mailto:[EMAIL PROTECTED] mailto:[EMAIL PROTECTED] <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
