Don,
Thanks. I obviously didn't drill down under Transaction Sets. Found it.
Rachel
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, August 14, 2001 8:20 AM
To: [EMAIL PROTECTED]
Subject: RE: 271 Transaction Disclaimer
Rachel,
If you go to "www.wedi.org/snip", will take you to the SNIP home page.
Then click on "Snip Work Products" on the left margin, will take you to the
list of work groups.
Then click on "Transactions White Papers" in the list of products, will
take you to the Transactions WG work products.
Then click on "Trading Partner Agreements", this is the white paper.
Hope this helps,
Don
"Rachel Foerster" <[EMAIL PROTECTED]>@wedi.org on 08/13/2001 08:40:11
PM
Please respond to <[EMAIL PROTECTED]>
Sent by: [EMAIL PROTECTED]
To: <[EMAIL PROTECTED]>
cc:
Subject: RE: 271 Transaction Disclaimer
Don,
I would agree.
However, I don't recall seeing the Business Issues White Paper. I also just
searched the SNIP web site and couldn't find anything there either.
Where does one find this white paper?
Thanks,
Rachel
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Monday, August 13, 2001 4:36 PM
To: [EMAIL PROTECTED]
Subject: RE: 271 Transaction Disclaimer
To Chris and all,
I've been watching/reading this thread and would like to suggest that this
not become a new white paper, but rather become a revision to the white
paper that was already developed by the Business Issues Sub Work Group
regarding Trading Partner Agreements and Companion Documents. I believe
this should become a sub-topic to that document. Perhaps there are several
sub-topics to consider, but the need for TPA's has already been described
along with their limitations.
Don Bechtel
"Christopher J. Feahr, OD" <[EMAIL PROTECTED]>@wedi.org on 08/13/2001
03:09:32 PM
Please respond to <[EMAIL PROTECTED]>
Sent by: [EMAIL PROTECTED]
To: <[EMAIL PROTECTED]>
cc:
Subject: RE: 271 Transaction Disclaimer
Thank you very much, Rachel. As I suspected, there is quite a lot to this
"TPA issue" and your email looks like a pretty decent draft-outline for a
paper. Perhaps someone could create a "TPA-Wizard" application that
conducts an interview .... resulting in a nice, searchable
rules-of-engagement book to post on the company website or print up as a
contract. Or WEDI-SNIP might consider publishing some "standard" or
prototype rule-books that people could freely copy/modify and present to
their trading partners as their own. There do seem to be some unmet needs
here.
Thanks again,
-Chris
At 01:09 PM 8/13/01 -0500, you wrote:
>Chris,
>
>Your elaboration is informative. I acknowledge that "contracted" providers
>already are under some contract (agreement) and that this
contract/agreement
>could be modified to incorporate any new HIPAA-related terms and
conditions.
>
>My concern is that there could be a naive perception that EDI trading
>partner agreements should also now be entered into. That's the impression
I
>came away with after reading the IG's. It's this scenario that both
William
>and I have a concern about, since it's not reasonable or feasible for
these
>types of trading partner agreements to be consummated easily and quickly.
>
>In my consulting business I caution my clients to stay away from "EDI
>trading partner agreements" because they typically become show stoppers
and
>deal breakers. Rather, I advise that a more comprehensive implementation
>manual be developed (most typically by the larger of the trading partners)
>which not only specifies the technical details of the transaction sets to
be
>exchanged (this could equate to the HIPAA IG's), but also serves to align
>the business semantic of the data to be conveyed by the EDI transaction
>(again, the HIPAA IG's address this, but there still seems to be room for
>interpretation), establishes the business rules for the interface -
>including not only the business rules to be applied to the data, but the
>business rules that control the process and the business relationship, and
>also provides all of the other information needed to successfully
establish
>and electronic business message exchange, such as communications
>methods/modes, use of VANs, clearinghouses, Internet, message security
>requirements, hours of operation, anticipation processing turnaround
cycles,
>key contacts, etc. In other words, just identifying the data and the
format
>is the first step, and all of this other "rules of engagement" must also
be
>provided if there is to be any hope of a speedy, accurate, timely, and
>working electronic business message exchange.
>
>Right now it appears to me that much of this information is scattered all
>over the universe and trying to pull it together into one comprehensive
>guide is daunting for even the largest and most sophisticated of
>enterprises, let alone for the smaller ones. Successfully establishing an
>integrated (or even a read/rip/rekey) EDI interface is not a walk in the
>park - witness the fact that no other industry anywhere in the world has
>been able to get beyond a 20% adoption rate (at best), and now we're
>expecting this highly fragmented health care industry composed of mostly
>small to medium businesses to achieve in two years what other major
>industries with somewhat unlimited resources could not and have not
achieved
>in over two decades of trying!
>
>I give our industry gold stars for attempting this, but the proof will be
in
>the pudding, which we'll all have to be eating in 2-3 years (or less now
for
>EDI)!!
>
>Perhaps a white paper might be helpful on this topic.....
>
>Rachel
>
>Rachel Foerster
>Principal
>Rachel Foerster & Associates, Ltd.
>Strategies for Electronic Commerce
>39432 North Avenue
>Beach Park, IL 60099
>Phone: 847-872-8070
>Fax: 847-872-6860
>http://www.rfa-edi.com <http://www.rfa-edi.com>
>
>
>
>
>
>-----Original Message-----
>From: Christopher J. Feahr, OD [mailto:[EMAIL PROTECTED]]
>Sent: Monday, August 13, 2001 11:24 AM
>To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
>Subject: RE: 271 Transaction Disclaimer
>
>
>Rachel,
>I think I understand the valid points that you and William are making
about
>the potential burden of trading partner agreements. I find it hard to
>fault this as a recommendation. But if the law and the implementation
>guides are clear enough, I doubt that very many people will require TPAs
>solely for the process of moving information around. I am a provider and
I
>do have to sign some kind of "provider agreement" with every insurance
>company I want to be bound to as a "contract provider". In the cases
where
>I'm billing a payor without such a contract, I am essentially acting as
the
>patient's agent, in which case the patient's contract with the payor would
>apply. I'm just proposing that payors insert any words or disclaimers
they
>feel are necessary (about EDI, HIPAA, etc.) into the existing
>contracts. If transactions are currently taking place without a specific
>contract between the "communication partners", then I don't see why that
>could not continue that way in the post-HIPAA world.
>
>But maybe there is more to it. If you feel that payors are about to waste
>a lot of resources trying to implement this "recommendation" for an
>agreement with every potential partner, then maybe a white paper should be
>developed, making the case for a TPA in certain situations... relying on
>the clarity of the IG and the law in all others.
>
>Regards,
>-Chris
>At 10:19 AM 8/13/01 -0500, Rachel Foerster wrote:
> >Chris,
> >
> >While your response was informative relative to the transmission of a
> >disclaimer statement within the 271, it did not address what I believe
is
> >William's core question. That is, the apparent recommendation in all of
the
> >IG's themselves that trading partner agreements be entered into to
address
> >certain business rules, and the fact that it most likely is not feasible
>nor
> >reasonable to expect providers and payers to enter into such trading
>partner
> >agreements on any mass scale.
> >
> >As a matter of fact, the federal government, when it first transitioned
to
> >EDI from their proprietary ways in the early-middle 1990's initially
> >required a trading partner agreement be entered into between the
>contracting
> >office and the potential supplier. This requirement all but killed the
> >federal government's (I believe it was actually the DOD) EDI effort and
>they
> >quickly (within 6 months) killed the use of trading partner agreements.
> >
> >Other industries have long since recognized that trading partner
agreements
> >are the deal breakers when two enterprises trying to establish EDI
> >interfaces between their respective systems and have long since
discarded
> >them in favor of implementation manuals that don't have the aura of
legal
> >requirements that gets the lawyers involved.
> >
> >Rachel Foerster
> >Principal
> >Rachel Foerster & Associates, Ltd.
> >Strategies for Electronic Commerce
> >39432 North Avenue
> >Beach Park, IL 60099
> >Phone: 847-872-8070
> >Fax: 847-872-6860
> >http://www.rfa-edi.com <http://www.rfa-edi.com>
> >
> >
> >
> >-----Original Message-----
> >From: Christopher J. Feahr, OD [mailto:[EMAIL PROTECTED]]
> >Sent: Sunday, August 12, 2001 5:36 PM
> >To: [EMAIL PROTECTED]
> >Subject: Re: 271 Transaction Disclaimer
> >
> >
> >William,
> >I think the original question was regarding the best place to insert
> >disclaimer text in the 271, stating that the response was not a
guarantee
> >of payment. Someone did suggest a suitable field for it, but it seems
> >unlikely that a provider (human) would ever see it there... unless they
had
> >specifically programmed the receiving system to capture that text and
> >display or print it.
> >
> >Disclaimers should be reserved for the truly unsophisticated user...
> >someone who is actually *likely* to make the error out of ignorance or
> >misunderstanding. A patient might make this mistake, and since the
patient
> >is not a covered entity, you would have great flexibility with the
> >disclaimer text placement. (I recommend not bugging the doctors with
this
> >stuff.)
> >
> >Regards,
> >-Chris
> >
> >At 07:01 PM 8/10/01 -0400, you wrote:
> > >Sandy Young, Joey Lawhorn and Christopher J. Feahr all tell Dana Grant
> > >that "section 1.3.10 [in the HIPAA IG ASC X12N 270/271 004010X092]
> > >encourages disclaimers to be outlined in the trading partner
agreement."
> > >
> > >A na�ve question: how does every payer in the country maintain a
trading
> > >partner agreement with potentially every provider they'll ever deal
> > >with?
> > >
> > >TPAs....oops, "companion documents" ... "should not be required for
> > >acceptance of a transaction as valid." The payer "may not reject the
> > >transaction merely because they cannot process an explicit request."
> > >
> > >William J. Kammerer
> > >Rachel Foerster & Associates, Ltd.
> > >
> > >
> > >
> > >
> > >**********************************************************************
> > >To be removed from this list, send a message to:
> >[EMAIL PROTECTED]
> > >Please note that it may take up to 72 hours to process your request.
> >
> >Christopher J. Feahr, OD Vision Data Standards Council
> >Executive Director http://visiondatastandard.org
> >Cell/Pager: 707-529-2268 [EMAIL PROTECTED]
> >
> >
> >
> >**********************************************************************
> >To be removed from this list, send a message to:
> >[EMAIL PROTECTED]
> >Please note that it may take up to 72 hours to process your request.
> >
> >
> >
> >**********************************************************************
> >To be removed from this list, send a message to:
>[EMAIL PROTECTED]
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>
>Christopher J. Feahr, OD Vision Data Standards Council
>Executive Director http://visiondatastandard.org
>Cell/Pager: 707-529-2268 [EMAIL PROTECTED]
>
>
>
>**********************************************************************
>To be removed from this list, send a message to:
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>
>
>
>**********************************************************************
>To be removed from this list, send a message to:
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Christopher J. Feahr, OD Vision Data Standards Council
Executive Director http://visiondatastandard.org
Cell/Pager: 707-529-2268 [EMAIL PROTECTED]
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