You might keep in mind that the biggest payer is CMS and they use intermediaries (CH) typcially BC/BS affiliates. Regards, Dave Frenkel ----- Original Message ----- From: William J. Kammerer <[EMAIL PROTECTED]> To: WEDi/SNIP ID & Routing <[EMAIL PROTECTED]> Sent: Monday, January 21, 2002 8:02 PM Subject: More on Directories....
> Kepa Zubeldia responded to Joe Barton on the WEDi Transactions Listserve > on Friday, 09 November, 2001, in "Re: Provider Confusion: The Routing > Problem, or What's my Name?" > > But, if I am a provider, and a patient comes with an ID card > that says that ACME insurance Payer ID is 1234567890, how do > I know whether this claim goes through Clearinghouse A, > Clearinghouse B or directly to ACME? > > Evidently, if I send it directly to ACME, I should have a > password to access their system. > > Same problem for a payer. Let's say a payer wants to send > 835 to all of its providers. How will the payer know which > provider is connected through which clearinghouse so the files > can be put in the correct queue? The provider ID does not > answer the question of which is the route for this transaction > to that provider as of today. > > This is related to the questions I asked Chris Feahr yesterday: why the > heck should the provider (or payer) have to make decisions about which > CH to go through to get hold of a particular payer? Or vice versa (payer > to provider). Can't Clearinghouses do interconnects? > > If a payer or provider has to make all these decisions itself, why > doesn't it just save itself the hassle and go direct - point to point? > Then it might be useful to have a "central payor address/routing > directory." But as we've seen discussed, there might not be incentives > for anyone to put such a thing together. > > William J. Kammerer > Novannet, LLC. > > >
