Greg,
I don't know how an organization could process an EDI transaction
without somehow knowing or having the particular EDI 'companion' guide
the sender is using.  Assumptions could be made but I think we all know
what problems that can cause.

Regards,

David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
www.gefeg.com
425-260-5030

-----Original Message-----
From: Koller, Greg [mailto:[EMAIL PROTECTED]] 
Sent: Sunday, June 02, 2002 8:45 AM
To: David Frenkel; [EMAIL PROTECTED]
Subject: RE: TA1 responding to non-participating health care providers

David,

Isn't a manual review defeating the purpose of administrative
simplification?  The concept of accepting an unknown transaction and
reviewing it manually pretty much eliminates savings associated with the
substantiation of HIPAA.

Greg Koller
Manager of Operations and Business Development
United Wisconsin Proservices
(414)226-5520
[EMAIL PROTECTED]
Be sure to visit our website at http://www.uwproservices.com/
 


 -----Original Message-----
From:   David Frenkel [mailto:[EMAIL PROTECTED]] 
Sent:   Friday, May 31, 2002 1:59 PM
To:     [EMAIL PROTECTED]
Subject:        RE: TA1 responding to non-participating health care
providers

It wouldn't be that difficult to have a dedicated, stand alone server,
outside any firewall that could accept unsolicited EDI transactions.
The server could be 'unloaded' and the transactions probably manually
reviewed.

P.S. People are doubling up listserv emails by putting the listserv name
in the 'To' AND 'CC' address lines.  Only one is necessary. Thanks.

Regards,

David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
www.gefeg.com
425-260-5030

-----Original Message-----
From: Bruce T LeGrand [mailto:[EMAIL PROTECTED]] 
Sent: Friday, May 31, 2002 11:16 AM
To: [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]
Subject: RE: TA1 responding to non-participating health care providers

I guess the difference, in our form of looking at transactions, is that
I have
a completely competent computer "opening the envelope", with every known
trading partner in it's databases. Instantaneous determination, rather
than
ending up in a waste basket because no one knew who to do what for.
------------------( Forwarded letter 1 follows )--------------------
Date: Fri, 31 May 2002 12:44:50 -0500
To: [EMAIL PROTECTED]
From: Rachel.Foerster[rachelf]@ix.netcom.com.comp
Sender: [EMAIL PROTECTED]
Reply-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.

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