Jim,
I think we should be cautious here, with your statement.
Many providers will want to be paid with electronic funds 
transfers ( after all Congress did require designation of a Claim 
Payment 
Standard in HIPAA) and that will involve the banking system. 

Our interpretation of the Final Rule indicates it does not require 
adding functionality that does not currently exist.  Therefore if a 
Payer in this example, does not currently have functionality to offer 
electronic funds transfer, or clearinghouse transfer as payment 
options ... they are not required by HIPAA to make that enhancement.  
By way of explanation about the 820 and 835 specifically, page 50333 
of the Rule says:

The implementation specifications for the ASC X12N 835 and 820 
transactions contain two parts, 
- a mechanism for the transfer of dollars and 
- one for the transfer of information about the payment, 
and allow these two parts to be transmitted separately. 

Consistent with the implementation specifications, actual payment may 
be sent in a number of different, equally acceptable ways, including 
check and several varieties of electronic funds transfer. 

So our belief is that we need to support the options of sending and 
receiving data electronically.  We are not required to add 
functionality / logic to support the processes required to offer 
transferring funds electronically, since the system does not support 
it today.  

Marsha

Verizon Information Technologies, Inc. 
Managed Care Division  Phoenix, AZ
Phone - 602.678.6042
Fax     - 602.678.6331
E-mail - [EMAIL PROTECTED]


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---------- Original Text ----------

From: <[EMAIL PROTECTED]>, on 10/6/01 12:22 PM:
To: smtp[<[EMAIL PROTECTED]>]

Your question may bring up more options than you might have expected. 
Providers may contact you through clearinghouse/remittance processing 
vendors, through their banks, or directly, and ask for a variety of 
claim 
payment options.  A provider opting to receive the electronic 
remittance 
information through a network of clearinghouses and vendors will have 
them 
contact you indicating that those vendors are ready to accept/test on 
behalf 
of that provider. Many providers will want to be paid with electronic 
funds 
transfers ( after all Congress did require designation of a Claim 
Payment 
Standard in HIPAA) and that will involve the banking system. There are 
several execution options including sending the 835 remittance data 
with the 
electronic funds transfer through the banking system or sending the 
money and 
data separately. All of these can be accomodated by the 
HIPAA-compliant 835. 
By the way, set up of electronic payment options  should not be done 
based on 
incoming information on an 837. 

Jim Moynihan
McLure-Moynihan, Inc.
Agoura Hills, CA 91301
818-706-3882
[EMAIL PROTECTED]


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