Re: Payor identification codes for 837I

[Ronald Bowron]

Before attempting to apply technology to the problem, we first need to understand the existing business processes that are required to be managed and the problem we are trying to solve.   It is my understanding that the ISA may only be one part of the problem.  The ISA only manages sender and receiver, or point to point data transfer.  Where this gets complicated further is that each claim within the transaction may have different receiver/payer data.  Therefore, I believe the routing issue needs to address file, batch and transaction level routing issues.   Once the appropriate levels for which routing criteria are identified, then we can discuss how each level should be managed.   It is my belief that a properly defined Trading Partner table or directory could address these issues, how that table is managed or stored and accessed during processing (SQL-RDBMS, LDAP-X.500, DSML-XML Directories, ebXML Repository, .etc) should be left to the organizations to define as part of their development requirements.  But the means of publicly publishing that information should be standardized (i.e. potentially via UDDI).   What I'd like to see come out of this discussion list is the basic set of elements or attributes necessary to ensure the proper routing of data within the EDI framework (i.e. What should the table or directory structure contain).     Another issue that needs to be addressed is the authorization component between trading partners.  Medicare and Medicaid may accept 837 claims, but that doesn't mean everyone has been authorized to submit such data.     Regards, Ronald Bowron