Per William's request, I'm posting this response to the list. I had
originally sent it directly to William.


William,
 
To be honest, I haven't thought much about specific data elements.  I
was more interested in ensuring that user's of the CPP have the ability
to establish testing requirements as well as production requirements.
 
Getting down to the ISA routing level:
It would be nice if everyone had the ability to process transactions
based on the testing indicator as recommended by the X12 User Guides. 
And that all the information in the ISA would be used for both
Production and Testing.  Then the only data element to change when going
live would be the Test/Production indicator.  The problem with this
indicator is it is not transaction specific - therefore it assumes all
transaction within the interchange are valid for production.  This is
not always the case - for example, an entity may be in production with
sending eligibility requests, but not claims.  
 
Also, not many institutions have used the T/P indicator properly.  Most
organizations didn't setup their test environments to represent their
production environments when it comes to sender and receiver ID's. 
Therefore, a sender may have one ID for testing and another for
production - assuming the ID is dictated by the receiver (i.e. via ZZ
codes).  It's possible that some may consider building x-ref tables to
address this and the use of standard identifiers like the D&B numbers.
 
With regards to the specific data elements that are released in the
CPP, I somewhat agree with your analogy regarding ABA and other types of
information.  Once they are in the public domain, we don't have much
control over how and when they get used.  But, if such information can
only be used to benefit (i.e. receive deposits), then there is no reason
for concern.  But, if such information can be used to access protected
assets (i.e. make withdraws/payments), then different levels of
protection may be required.
 
With regards to "Certification".  "Certification" will not guarantee
that the transactions are not fraudulent, only that they are properly
formatted and contain valid content based on the standards.  Not that
the content is appropriate for payment.
 
So, much like the Public Trust model discussed in another thread, when
does one consider a business entity a trusted entity?  How do you
determine whether or not payment is valid?
 
In the old days, when a patient was "Out of Network", the physician
simply billed the patient.  It was the patients responsibility to
forward the claim to the payer (this is still used today, my dentists
bills this way).  The payer then knows that the patient actually did
visit the physician and received the services.  With the CPP, does this
become an automated process?  What roll will the patient play, if any,
to ensure the claim is sent to the proper insurance plan for payment? 
How does the Insurance Plan verify that the patient actually received
the billed services?
 
I didn't post this to the list, because much of it is out of scope, but
I believe without answers to these types of questions, the CCP may not
have many early adopters.
 
-Ronald Bowron

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