Maybe the payer could simply put the qualifier (e.g., NAIC or National Payer ID) and the number on the back of the insurance card the patient carries around: it could be squished in with the P.O. Box address for paper claim submissions!
That ID would be used as the receiver ID in the ISA. The dream: any VAN or Clearinghouse worth its salt should be able to route the claim or eligibility inquiry safely, securely and reliably to the payer. Why should every optometrist in the land have to look up this stuff in the "central payor address/routing directory" - even if such a thing existed - when the CH or VAN could do it just as easily? And if the directory didn't exist, why couldn't the VAN or CH see that it doesn't recognize the NAIC code as belonging to one of its customers, and automatically set up the interconnect? The VAN or CH could query every other intermediary it knows about to see if they own a direct connection. Failing that, it could look up the code itself in the NAIC database (saving the provider the hassle of buying one) and manually resolve where to send the transaction electronically, even if it means calling the payer for the information. Shouldn't this be part of the "value-add" in VAN? I'm not particularly enamored of the idea of centralized databases - maintained by the Government or otherwise - not due to suspicion of Big Brother, but simply because there's no incentive to do the job right. Instead, it's much more likely VANs or Clearinghouses can solve these problems on their own. Though cooperation between profit-making organizations sounds counterintuitive, the ones who do just this (i.e., share information to better serve their respective customers) will probably make out in the long run. William J. Kammerer Novannet, LLC. ----- Original Message ----- From: "Christopher J. Feahr, OD" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]> Sent: Saturday, 19 January, 2002 06:19 PM Subject: RE: Payor identification codes for 837I Regarding the unique routing ID for the payor (NAIC code?)... whatever it is, MUST be maintained in a central directory. At least, that's my vote as a small provider. People walk through my door unpredictably with all sorts of insurance plans and if it was EASY/PAINLESS to determine where to send a standard elig. query and/or a std. claim, then I'd be less inclined to require the patient to pay cash and duke it out on his own with his insurance company. A central payor address/routing directory seems like a vital component. -Chris
