The issue here really gets down to "requiring" that the information be sent. The
provider's system should be set up not to send the information, and the plan's system
should be set up not to accept this information. One of the dangers here is that
plans would begin to rely on this "extra" information, and then start to "strongly
urge" that it be sent. We then start moving away from standards.
Stanley Nachimson
Office of Information Services, CMS
410-786-6153
>>> [EMAIL PROTECTED] 09/24/01 11:10AM >>>
John,
I agree that sending this information (like marital status) would be
non-HIPAA-compiant, but NOT rejecting the information and even storing it
would not appear to be a problem. I'm not sure that I see a compelling
business reason to store such data, but if this company wants to adopt a
"better safe than sorry" approach to data elements in the 4010 that were
excluded from the HIPAA std., then wouldn't this be OK... provided they did
not send them OUT to anyone?
Thanks,
-Chris
At 02:41 PM 9/21/01 -0400, [EMAIL PROTECTED] wrote:
>The way I understand it is that if those fields are even sent on a
>transaction, the sender is not HIPAA compliant. If you are using a
>commercial translator, the fields will not be allowed in.
>
>I would not store them if they are received.
>
>
>John Lilleston
>Business Process Specialist
>Verizon Information Technologies, Inc.
>813-979-3225
>[EMAIL PROTECTED]
>
>
>
>
> "Graff,
> Chris"
> <[EMAIL PROTECTED] To:
> "'[EMAIL PROTECTED]'"
> om> <[EMAIL PROTECTED]>
>
> cc:
>
> 09/19/2001 Subject: 4010 Transaction
> vs. HIPAA Compliance
> 04:27
> PM
> Please
> respond
> to
>
> transactions
>
>
>
>
>
>
>
>
>
>Hello all. We are working on a HIPAA data store and claims processing
>application. There is a question that has been plaguing our minds here.
>
>If you look at the 4010X098 or 4010X096 manuals, there are many fields that
>state "Not Used." Because these fields are not used, I was under the
>assumption that we should not store this data. For the majority of these
>fields, this is a no-brainer. Some of the NM1 loops specifically can hold
>information that would never pertain to certain entities within the loop.
>For instance, there is no reason to keep track of NM111(Entity
>Identifier's)
>for the submitter loop.
>
>Some pieces of data, however, seem to be elements that providers or payers
>may be keeping track of at the moment. One in particular that we found was
>the marital status element, which is on a normal UB-92(locator 16), but is
>listed as not used in the 4010X096 manual. Once we found this difference a
>number of different questions came up.
>
>1. Do we accommodate for this field because it is on the form, and there
>might be a chance that this particular data element might be passed through
>our processing system?
>
>2. If we accommodate for this field, does that make us not HIPAA compliant
>because we have claims running through the system that contain non-HIPAA
>compliant data?
>
>3. Should we just accommodate all the possible fields that could appear on
>a 4010 even though it states in the manuals that they are specifically not
>used? Once again would we then be not compliant if we did?
>
>Any thoughts on these questions would be greatly appreciated.
>
>Thank you,
>
>Chris Graff
>United Wisconsin Proservices
>(414)226-6022
>800-822-8050 x6022
>[EMAIL PROTECTED]
>
>
>
>
>
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>
>
>
>
>
>
>
>**********************************************************************
>To be removed from this list, send a message to: [EMAIL PROTECTED]
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Christopher J. Feahr, OD
http://visiondatastandard.org
[EMAIL PROTECTED]
Cell/Pager: 707-529-2268
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