David, Ruth has a valid point and is actually supported by your response. The section in the regulation is 162.925(2) A health plan may not delay or reject a transaction, or attempt to adversely affect the other entity or the transaction, because the transaction is a standard transaction. I think it's important to note that the requirements says "delay" or "...adversely affect".
The word "delay" is relative to the receiving entity and the situation and "adversely affect" is relative to the sender. So the argument is: if a plan provides eligibility information, down to the benefit level, real-time via the telephone but decided to respond yes/no to the 270/271 thereby requiring a phone call and "delaying" a response and "adversely" affecting the other entity that sent a standard, would that be in violation of section 162.925(2)? The provider sends a "standard" and gets less, it could be construed as being adversely impacted. Any thoughts? Lindsay -----Original Message----- From: David A. Feinberg, C.D.P. [mailto:[EMAIL PROTECTED]] Sent: Tuesday, February 12, 2002 9:11 PM To: [EMAIL PROTECTED] Subject: Re: 270/271 Question -- Before vs. After Ruth, As far as I know, there are no "before" versus "after" requirements for HIPAA. What anybody does before has no bearing on the requirements for compliance after. Thus the undefined word "delay", a relative as opposed to absolute term, would have to be operationally and case-by-case defined unless DHHS provides some additional official explanatory materials (e.g., the future Enforcement regulation). Can you cite any regulatory language that I may have missed? Thanks. Dave Feinberg Rensis Corporation 206-617-1717 [EMAIL PROTECTED] ----- Original Message ----- From: "Tucci-Kaufhold, Ruth A." <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, February 12, 2002 1:14 PM Subject: RE: 270/271 question Does this discussion fit under that category of "an entity cannot delay a transaction?" My interpretation of that is an entity cannot delay any of the transactions from "before HIPAA". So, if their reply "today" includes more information than yes/no ... isn't there some sort of "obligation" to at least provide what is being given today? If not, and they say yes/no and say if you want more ... isn't that "delaying" the transaction? Maybe I'm too logical? Ruth Tucci-Kaufhold UNISYS Corporation 4050 Innslake Drive Suite 202 Glen Allen, VA 23060 (804) 346-1138 (804) 935-1647 (fax) N246-1138 [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] Please note that it may take up to 72 hours to process your request.
