Sorry - I just did a reply earlier and usually that gets where it needs to
go.
----- Forwarded by Robert D Poiesz/ISG/CORP/Highmark on 01/22/2002 11:47 AM
-----
"William J.
Kammerer" To: "Bob Poiesz"
<[EMAIL PROTECTED]>
<wkammerer@nov cc:
annet.com> Subject: Re: More on Directories....
01/22/2002
11:11 AM
You may be right - there are some good points there. But I think it has
to be discussed in the open - would you mind posting your comments to
the WEDi/SNIP ID & Routing mailing list?
William J. Kammerer
Novannet, LLC.
+1 (614) 487-0320
+1 (614) 638-4384 (c)
+1 (928) 396-6310 (FAX)
----- Original Message -----
From: <[EMAIL PROTECTED]>
To: "William J. Kammerer" <[EMAIL PROTECTED]>
Sent: Tuesday, 22 January, 2002 10:59 AM
Subject: Re: More on Directories....
This gets back to "What is the real problem?"
We store the necessary data for sending our outbound transactions to the
first stop in an unknown number of stops to get to the provider. The
provider tell us who should get their transactions. In our case, we
have
our own mailbox system (we are part clearinghouse in that we support
multiple payers). So, we send and receive the interchanges via the
appropriate mailbox and everything is automatic. We store the necessary
routing information in our system and our trading partner guide
identifies
our ID requirements because that is our job. Those ID requirements are
integrally tied to our system and access security. If our intent is to
standardize those pieces, then I have a problem - I don't think that we
are
ready to go there, and I don't want to go there. We haven't even
touched
on access security and I don't think that we can until there are
national
IDs in place.
I see this as internal to the VANs and Clearinghouses.
Bob
"William J.
Kammerer" To: "WEDi/SNIP ID &
Routing" <[EMAIL PROTECTED]>
<wkammerer@nov cc:
annet.com> Subject: More on
Directories....
01/21/2002
11:02 PM
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.
