Its been very interesting catching up on all of the "routing" messages over the last week regarding this subject. What seems to have been missed, but Rachel caught, is that the CPP is simply an instrument to create the CPA - which is the electronic equivalent of the trading partner agreement.
I would certainly agree with all of the payer comments regarding trade with "unknowns", but the CPP exchange is our electronic (but certainly applies to semi- or even non-electronic) equivalent to "discover" information about the prospective trade partner. In my second paragraph of the "Conceptual Schematic" paper I state: "The data sets to be communicated should be comprehensive enough to allow for a fully mechanized (no human) interaction, but the communication of such information does not necessarily have to be in a single transaction. In other words, exchange of all data necessary for loading trading partner tables and initiating EDI trade can be in multiple exchanges. The first exchange to identify and gather basic information, and a second and third more secure exchange to provide sensitive information which is not meant for display in a public setting." I would further emphasize that if we assume for the moment that all data and signatures needed to create a physical TPA can be "computerized", then the CPP, even if printed out and snail-mailed back & forth can constitute creation of a trade agreement. We definitely need to realize that most of us will need transition time between the ultimate electronic future and where we are today (which is with a file cabinet full of paper agreements). The transition will be gradual as many people have observed, but we still have to paint the target to shoot at. I propose that we take the conceptual model that we are working out, and apply it to a few real TPAs to fill the gaps. Then have all of you out there with TPAs do the same. When we are done, we should have a pretty comprehensive list of elements, and a pretty sound structure from which to build. In the future state, when a transaction arrives from an unknown, the unknown's CPP can be accessed as a first step, and a CPP exchange can ensue (whether automated or manual or somewhere in-between, as internal company policies dictate). Through that process, the prospective trading partners may discover that they really don't want to do EDI. That's OK. But the legitimate providers & plans who do conform to the CPP standard & protocol - even if in a manual process - will have a much simpler way of consummating an agreement and beginning EDI. Dave Minch T&CS Project Manager John Muir / Mt. Diablo Health System Walnut Creek, CA (925) 941-2240 -----Original Message----- From: Rachel Foerster [mailto:[EMAIL PROTECTED]] Sent: Friday, May 31, 2002 10:45 AM To: [EMAIL PROTECTED] Subject: RE: TA1 responding to non-participating health care providers Bruce, I agree that you most certainly don't want to respond to an eligbility inquiry without first authenticaing the information receiver. But, this has nothing at all to do with taking the EDI interchange into your electronic mailroom. There's a multi-step process here with various levels of validation and authentication required (that are different or similar) at each level. For example, if an envelope arrives at your company's mailroom, does the mailroom clerk look at the return address and the receiver's address and make a determination to throw it away or mark it return to sender? I bet not! That envelope is passed to another activity that performs certain levels of validation, like opening the envelope, examing the content, and making some determination as to what to do with the content. Rachel Rachel Foerster Principal Rachel Foerster & Associates, Ltd. Professionals in EDI & Electronic Commerce 39432 North Avenue Beach Park, IL 60099 Phone: 847-872-8070 Fax: 847-872-6860 http://www.rfa-edi.com -----Original Message----- From: Bruce T LeGrand [mailto:[EMAIL PROTECTED]] Sent: Friday, May 31, 2002 9:03 AM To: [EMAIL PROTECTED] Cc: WEDi/SNIP ID & Routing Subject: RE: TA1 responding to non-participating health care providers I agree, up to a point. But I still say that a form of pre-qualification must exist, at the trading partner level. The last thing I want to do, as a payer, is disclose eligibility data about one of my customers to someone not eligible to receive said data, also a clear violation of the only part of HIPAA with judicial recourse. And that puts us back to a trusted relationship with whomever is requesting the information.
