One other thing to consider in this discussion: Don't forget the power of the market place - there's more to life than what is in the HIPAA law. Payers have the option to make a business decision to charge providers for paper/manual transactions or to make it otherwise financially untennable to not go EDI. Providers may thus get an incentive to upgrade their systems sooner rather than later. Payers are investing millions in upgrading their systems and, realistically, cannot afford to have an increase in manual/paper processes. While HIPAA is a law it is primarily a business strategy.
Jan Root "Rishel,Wes" wrote: > Tracey, > > You seem to believe that you will be forced go back to paper if you are > ready on the new format and the payer is still on the old format. That is > not an inescapable conclusion. One would hope that your approach to HIPAA > would allow you to selectively use an old format or the new format on a per > health plan basis. This should not be too much of a challenge since you > currently are required to use different formats for different health plans. > > Your job is to use that capability to switch to the new format for each > health plan. > > It has never been remotely possible that all health plans would switch to > the new formats at exactly the same time, so this has always been a > requirement. The extension just prolongs the time frame where you must > continue to support multiple formats. > > Wes Rishel > Board Chair, Health Level 7 > Vice President, Research Director > Gartner Research, Healthcare > Alameda, CA > 510 522 8135 > [EMAIL PROTECTED] > See us at the Gartner Healthcare Business and IT Summit > 15-17 April 2002 > Sheraton Boston Hotel > Boston, MA > > http://www3.gartner.com/2_events/conferences/hit4/hit4.jsp > > -----Original Message----- > From: Tracy A. Mitchell [mailto:[EMAIL PROTECTED]] > Sent: Friday, February 15, 2002 2:10 PM > To: [EMAIL PROTECTED] > Subject: RE: Must providers/billers comply with all formats > > Darn, I was afraid of that. We are a not-for-profit repricing PPO. Our > board of trustees is made up of MDs and DOs. I love EDI files and my > company will be HIPAA ready this year, but many, many providers have old > systems that they will not upgrade by Oct 2003. So, I suspect my > inbound EDI volume will drop and my data entry cost will go up over the > next few years. I was hoping that I could a least keep the ones that > could send NSF formats. I would support both. > > Oh well, at least the payers are suddenly returning my phone calls > regarding EDI. > > Mr. Tracy A. Mitchell > Director Information Services > Arizona Foundation for Medical Care > > -----Original Message----- > From: Sayman,William [mailto:[EMAIL PROTECTED]] > Sent: Friday, February 15, 2002 1:31 PM > To: '[EMAIL PROTECTED]' > Subject: RE: Must providers/billers comply with all formats > > Covered entities are required to use standard transactions. > > � 162.923 Requirements for covered entities. > (a) General rule. Except as otherwise provided in this part, if a > covered > entity conducts with another covered entity (or within the same covered > entity), using electronic media, a transaction for which the Secretary > has > adopted a standard under this part, the covered entity must conduct the > transaction as a standard transaction. > > ********************************************************************** > 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. ********************************************************************** 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.
