I'm moving the clearinghouse function to a wholly owned sub.  It can
receive whatever formats it wants and send them to the PPO as 4010
transactions.  That should work.

-----Original Message-----
From: Claudia J. Egan [mailto:[EMAIL PROTECTED]]
Sent: Monday, February 18, 2002 11:02 AM
To: '[EMAIL PROTECTED]'
Subject: RE: Must providers/billers comply with all formats


I would be worried that the repricing function is part of "payment" by
the
health plan and is performed by the network on the health plan's behalf.
(In other words, whose business associate is the network?)  If so, then
the
receipt by the network is receipt by a business associate of the plan,
and
the provider to PPO network electronic transaction is really a provider
to
plan transaction and must be compliant.  

Thoughts? 



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