Michael: Every health plan, if it does electronic transactions at all, will be required by HIPAA to support the 835 - both the Health care payment and the remittance advice. So every payer, after H-Day, which uses the Healthcare CPP and Registry (implying it is EDI capable) will have some kind of notation in its CPP (electronic partner profile) saying it supports not only both forms of the 835, but also all of the other HIPAA standard transactions applicable to their business.
The more variable side is that of the provider: generally it's optional for her to support the HIPAA standard transactions. She may support the inbound 271 and outbound 270 and 837, but prefers paper remittances and checks. It's problematical whether she really has to announce in her CPP that she sends 837s: the payer will know that when it receives one from her! But the payer does have to know which standard transactions the provider can accept; silence on the 835 would imply she doesn't support the 835 remittance. Now even though she doesn't take 835 EOBs, the provider may very well want to be paid electronically through her bank: our CPP extensions have to support some way of saying EFT payments are accepted, specifying her bank routing code and account number. William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 -----Original Message----- From: Michael Mattias/Tal Systems [mailto:[EMAIL PROTECTED]] Sent: Monday, May 06, 2002 1:29 PM To: 'WEDI/SNIP Listserve' Subject: Re: CPP Data elements draft for comment > Developing a requirements document....how novel! Slightly off this topic..? Do we need to have separate work teams for "registry data elements by [business?] transaction?" If so, I can help with 270/271 Eligibility Request/Response pair. I know the '835 Health Care Remittance' pretty well: see http://www.providerpaymentpartner.com for a product to process the 835; but about the only thing Sally Provider would need to know about a payer's remittance capability is, "ANSI Remittance Available Yes or No?". (Unless, of course, Sally is going to set up Ole Doc Smith's office in the registry to help all those payers route 835s to her..) Michael Mattias Tal Systems, Inc. Racine WI [EMAIL PROTECTED]
