Tracie,

As Jan indicated in her last paragraph, requiring providers to put
information in a loop that is different than the definition under HIPAA
(in this case there may actually be different billing and pay-to
providers) is not allowed.  Further, HIPAA specifically prohibits
trading partner agreements from, among other things, changing the
definition, data condition, or use of a data element or segment in a
standard.  (162.915)

So, I think that whether there is a contract or not, requiring providers
to only use certain of these fields or to use the fields for other than
what it is defined as would violate HIPAA.

Leah Hole-Curry
Fox Systems, Inc.
602-708-1045

>>> [EMAIL PROTECTED] 03/27/02 14:10 PM >>>
Tracie
I would respectfully add to Tom's comments.

I agree with Tom conceptually that the Billing should be the Pay-to (it
makes
life much easier!), but it is simply not always the case.  The "Billing
Provider"
may or may not be the entity receiving payments.  If the Billing
provider was
always the Pay-to then we wouldn't need two loops.

However, that said, nothing in HIPAA prevents you from structuring your
contracts
with your providers such that the Billing is always the Pay-to. You
could even
conceivably structure your contracts with your providers so that the
Rendering is
always the Billing is always the Pay-to.  The imp guide doesn't say that
these
have to be three separate entities. It just says that if they are three
separate
entities then they should be reported as such.  So, the question
becomes: who
defines who is the billing vs the pay-to vs the rendering?  The answer
is: the
payer-provider contract, and that varies by trading partner (in the
absence of a
contract, presumably anything goes).

So, whether it is kosher to always require your providers to put
'rendering' in
the 'billing' and to pay them as such, I would guess depends, in part,
on your
contractual relationship with them.

If you don't have a contractual agreement supporting this request than I
would
personally agree with your concern that requesting your providers to
always enter
the "rendering" into the "billing" loop may not be allowable under
HIPAA.  It
might constitute a violation of the HIPAA Transaction and Code set rule
which
might open you up to fines (sometime in the future).  In some ways, what
you are
proposing may not be an EDI question, it may be a legal question:  the
Transaction and Code rule specifically prohbits anyone from changing the
meaning
of any element.  By requiring your providers to always put a Rendering
in the
Billing, someone might argue that you have violated the rule.

Anyway, thems my 2 cents.

Jan Root






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