I can see software vendors wanting to say that they're "HIPAA
certified."   That's a great selling point - even if "certification" is
not mandated by law.  You as the doctor/practitioner want to have some
assurance that your software vendor can generate compliant transactions
(either onsite within your licensed software or at the vendor's site).
That little holographic label (the one saying "HIPAA certified for
ODs!") on your software box would give you, presuming you're an OD, some
peace of mind that you're not dealing with some fly-by-night software
vendor who could be responsible for holding up your claim payments.

But when push comes to shove, I believe the payer has to take your
purported standard transactions (whether you write the software yourself
or use an off the shelf package) - no ifs, ands or buts.  And if they're
not compliant standard transactions for some reason, I have to believe
the payer will have to return you something (an 824 or an e-mail)
promptly which clearly indicates at least where the first problem was
found.  So even if you didn't subscribe to a testing and certification
service, you could still manage to have the payer do your debugging for
you - as long as you wanted to wait for your payment!   Of course, this
is an issue for the WEDi/SNIP Testing Group and is none of our business.

"...if the doctors can get their own interchanges to the payors," then
it stands to reason the payers should have to return the responses
through some standard channel other than a "mail drop-box on the payors
server."  Why shouldn't the payer have to use the same means of
"discovering" where the provider is - say, Kepa's DNS "directory"?  If
the provider has said he takes e-mail'ed standard transactions as S/MIME
attachments encrypted using this here certificate, that seems like a
fairly standard and cost-efficient means of returning acknowledgements
and responses.  Forcing each provider to go through hoops polling an
untold number of payers' web sites to access a "drop-box" seems like "an
impediment to frictionless e-commerce and an extra cost providers can do
without." Where have I heard that before?

Power to the "little" people!  Just call me the Huey "Kingfish" Long of
EDI.

William J. Kammerer
Novannet, LLC.
+1 (614) 487-0320

----- Original Message -----
From: "Christopher J. Feahr, OD" <[EMAIL PROTECTED]>
To: "William J. Kammerer" <[EMAIL PROTECTED]>; "WEDi/SNIP ID &
Routing" <[EMAIL PROTECTED]>
Cc: <[EMAIL PROTECTED]>; "Scott Bussinger" <[EMAIL PROTECTED]>
Sent: Sunday, 10 February, 2002 02:45 PM
Subject: Re: Small Provider Software Vendors: Clearinghouse or mere
business assoicate?


I don't think there is any doubt that the vendor would make himself a
covered entity/CH if he was constructing the transactions and building
the interchanges for his doctor-clients.  But I don't really see this as
any more onerous for the vendor... "In for a penny, in for a pound".  If
the vendor isn't building error-free interchanges based on the
information streaming in from his doctors, then his doctors are still
going to expect him to have written the software to accomplish this
effectively "by remote control".  If the doctors and staff members are
the ones actually pushing the buttons and creating the messages, then
are we going to be able to certify "Acme OD Manager" software as "tested
and certified HIPAA compliant"... or will we have to certify each office
using the software? I don't know why a software vendor would not want to
offer a centrally managed [true CH] model to his doctor-customers.  But
to be fair and inkeeping with the letter of HIPAA, he needs to also
provide a theoretical point-to point path for the doctor to the payor
(and possibly back again).

Even if the doctors can get their own interchanges to the payors, the
return paths will not be easy for payors to figure out... leaving them
little other choice than the "mail drop-box on the payors server" option
described by Peter as essentially unfair for the provider.  When the
process matures to the present level of email routing, we *may* see
providers (and payors) unplugging from these CH-agents and going
direct.  But then "direct" is only an illusion and at the end of the
day, I really think doctors would rather not worry about this crap...
and get a monthly bill!

(But then you do have nutty doctors doing their own electrical wiring...
I'm one of them!)

Regards,
Chris



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