Marcallee Jackson has graciously offered to start the ball rolling on
Trading Partner Agreements - or, more correctly, how to avoid the paper
versions of them. As you'll recall from previous discussions, sometimes
the manual EDI enrollment processes and concomitant paperwork are so
complicated and take so long that providers are sometimes unwilling to
undertake the hassle, especially if their volume of claims to a
particular payer is relatively low.  That means more stuff is dropped to
paper when one or more of the parties can handle electronic
transactions.

Though the legal issues behind TPAs are - strictly speaking - not really
in our charter, the consensus seems to be that if it takes 2-8 weeks to
get the paperwork done for electronic trading, it would surely throw
some cold water on the ideal of providing automatic and instantaneous
means of "discovering" EDI addresses!  To see just what hassles a paper
TPA entails for Clearinghouses, see Marcallee's posting from 20
February, 2002: "It takes providers as long to complete their part of
the enrollment paper work for these payers as it does for most to
complete testing, implementation, training and full production for
payers who don't require it.  That's if the enrollment process goes
well."

Marcallee has arranged to have some legal folks she knows help us out in
determining TPA requirements under HIPAA (if any).  Right now, we have
Marcellee, Dave Minch and Rachel Foerster from our group working on this
effort.  We do already have representation from the Clearinghouse, Big
Provider and CMS perspectives. But there's still room for someone from
the Big Payer side of the house to help out - especially a Big Payer who
insists on paper TPAs and enrollments.  If you're a Big Payer, would you
volunteer by writing or calling me privately?

Marcallee believes the scope of this effort would entail:

1.  Electronic TPAs - machine readable documents that outline
information proprietary to the payer; e.g., information on routing and
information related to proprietary requirements for HIPAA transactions
(stuff that would normally be part of a companion guide).

2.  EDI Enrollment - This is a process today that requires the provider
to sign an EDI agreement before exchanging transactions.  This is a time
consuming process and a barrier to fuller utilization of EDI.  It's of
particular concern to providers and clearinghouses since many health
plans seem to be planning on this same requirement which could
dramatically impact cost and timelines to implementation.  Among other
payers, every Medicare intermediary requires this process today.  The
primary question would be - is this legal post HIPAA?  If yes, then the
second issue and third topic here would be:

3.  An EDI Power of Attorney - This would allow a provider to assign
their clearinghouse power to enroll them with other trading partners
(clearinghouses, payers, etc) for the purpose of exchanging healthcare
transactions.

Please also remember: we have a WEDi/SNIP ID & Routing teleconference
scheduled for Friday March 8, from 1:30 - 2:30 EST, 703-736-7290, pin
#1315331.

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


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