Rachel,
I think you might take into consideration the financial realities of the
healthcare industry.  I attached an article from the AHA newsletter
dated 4/17/02.

Regards,

David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
www.gefeg.com
425-260-5030

House lawmakers call budget 'political shell game,' say hospitals will
suffer Bipartisan House lawmakers today said the fiscal 2003 budget is a
"political shell game" without enough funding for prescription drug
coverage and program reform -- including adjustments to provider
payments. Ways and Means Committee ranking minority member Charles
Rangel, D-NY, said the coming Medicare bill, which Chair Bill Thomas,
R-CA, said would be out by Memorial Day, would be "politically
difficult" because it attempts to additionally fund provider givebacks
without new spending, "which means hospitals aren't going to get back
nearly what they were promised." Carl Levin, D-MI, said last year's tax
cut caused the administration proposal's necessity to deviate money from
hospitals and home health care. House Budget Committee Chair Jim Nussle,
R-IA, said rural help is needed due to doctors leaving and hospitals
closing down over "broken" payment systems. Health and Human Services
Secretary Tommy Thompson said only Congress could change the formulas
for paying doctors and hospitals.

+++


-----Original Message-----
From: Rachel Foerster [mailto:[EMAIL PROTECTED]] 
Sent: Wednesday, April 17, 2002 5:19 PM
To: [EMAIL PROTECTED]
Subject: RE: questions on the appropriate way to reply when there are
erro rs in a transaction request

Of course the 824 is not a HIPAA transaction....yet. Neither is the 811,
the
unsolicited 277, the 271 roster, the 275 (with an embedded HL7 message
no
less!), the 269, and so on. But anyone who writes their own EDI system
without the flexibility to add additional transactions that support the
full
business process has blinders on and is throwing good money after bad.

This first set of HIPAA transactions is not a one-time event....it's an
ongoing way of life with more to come. Remember when all we had in the
full
set of X12 standards was the 810, 820, 850, 855, 856????

Rachel
Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
Professionals in EDI & Electronic Commerce
39432 North Avenue
Beach Park, IL 60099
Phone: 847-872-8070
Fax: 847-872-6860
http://www.rfa-edi.com


-----Original Message-----
From: Heiert, David [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, April 17, 2002 12:34 PM
To: '[EMAIL PROTECTED]'
Subject: RE: questions on the appropriate way to reply when there are
erro rs in a transaction request


But is there some guarantee that the sending system will be able to
process this message?  If the system is only capable of dealing with
message types specified in the HIPAA regs, what happens when this
message
comes in??  Or is it a standard HIPAA message?

The previous message leads me to believe it is not...

-----Original Message-----
From: Bill Chessman [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, April 17, 2002 12:50 PM
To: '[EMAIL PROTECTED]'
Subject: RE: questions on the appropriate way to reply when there are
erro rs in a transaction request


Since there's no HIPAA IG for 824, the best bet would be to look at the
official X12 transaction set docs that are available by themselves (do
they
still do that?) or as part of the X12 books (your version of choice).
If
you don't have it, you'd need to pay for it.  It should be available
from
the X12 Secretariat (DISA) at http://www.disa.org.

Best regards,
Bill Chessman
Peregrine Systems, Inc.

P.S. Most X12 books are also available on CD (which can be very
convenient...and much more lightweight!).

-----Original Message-----
From: Diane Stapleton [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, April 17, 2002 6:16 AM
To: '[EMAIL PROTECTED]'
Subject: RE: questions on the appropriate way to reply when there are
erro rs in a transaction request


We've seen reference to the 824 Transaction set and we don't see
documentation out on the WPC website for this set.  Where can we find
more
information about this  824 Transaction set?

Diane Stapleton
Quovadx, Inc. (Formerly Xcare.net)
5051 Journal Center Blvd, NE - Suite 410
Albuquerque, NM  87109
1-505-248-3944
[EMAIL PROTECTED]


-----Original Message-----
From: Rachel Foerster [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, April 16, 2002 9:02 PM
To: [EMAIL PROTECTED]
Subject: RE: questions on the appropriate way to reply when there are
erro rs in a transaction request


Jonathan,

Yes. The 824 is not unnamed as you call it. It's been a valid X12
transaction for over a decade in widespread use in other industries. I
strongly recommend that the 824 be used to report errors re
non-compliance
against a HIPAA guide. It can be used now; however, there is a work
group at
X12 working on adding additional codes that will make it even more
useful to
report HIPAA guide non-compliance errors.

You seem to have a problem with this. Why?

Rachel
Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
Professionals in EDI & Electronic Commerce
39432 North Avenue
Beach Park, IL 60099
Phone: 847-872-8070
Fax: 847-872-6860
http://www.rfa-edi.com


-----Original Message-----
From: Jonathan Fox [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, April 16, 2002 1:27 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: questions on the appropriate way to reply when there
areerrors in a transaction request


Rachel,

So, are we left with the un-named 824 to report HIPAA-level (WEDI-SNIP
3-7)
errors?


Jonathan Fox
eCommerce Analyst
Independent Health
716-631-3001 x2472

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>>> [EMAIL PROTECTED] 04/16/02 01:54PM >>>
Ajay,

I totally disagree. The 997 transaction is specifically for the purpose
of
reporting syntax errors within functional groups and transactions
according
to the X12 standards. A transaction can comply with the X12 standards
and
not comply with the HIPAA guides. A covered entity conducting a
transaction
that does not comply with the HIPAA guides is subject to economic
penalties
under the law. The originator and receiver need to know explicitly if
the
transaction fails X12 validation or HIPAA guide validation. It's a huge
difference.

Furthermore, the 997 is not capable of reporting all HIPAA guide
compliance
validation errors. There must be firm and clear boundaries between
compliance with the X12 standard and compliance with the HIPAA guides.

Rachel
Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
Professionals in EDI & Electronic Commerce
39432 North Avenue
Beach Park, IL 60099
Phone: 847-872-8070
Fax: 847-872-6860
http://www.rfa-edi.com


-----Original Message-----
From: Ajay K sanghi [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, April 16, 2002 5:42 AM
To: [EMAIL PROTECTED]
Subject: RE: questions on the appropriate way to reply when there are
errors in a transaction request



My view is that to the maximum extent possible, translators should
handle
HIPAA guide validation failures using 997 and not stick to just X12
"standard" syntax validation.

If a "situational" element/segment, which is "required" in certain
condition
is missing, 997 should generate "Mandatory Data Element/Segment Missing"
code for such elements/segments  and likewise.

Ajay

 -----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On
Behalf Of Rachel Foerster
Sent: Tuesday, April 16, 2002 4:11 AM
To: [EMAIL PROTECTED]
Subject: RE: questions on the appropriate way to reply when there are
errors
in a transaction request





Jim,

When and on what basis to reject is basically a business/risk decision
on
the part of the receiver. However, I take the following view:

1. The entire interchange must pass the full X12 syntax validation. If
errors, fail and report via 997.

2. If interchange passes X12 syntax then apply HIPAA guide validation
rules.
If a transaction within the interchange does not comply with guide, fail
the
transaction and report via the 824. Keep in mind that validation also
includes validating medical and non-medical codes as being valid within
the
referenced code set.

3. If transaction passes HIPAA guide validation, pass transaction data
to
internal application and apply internal business rules. Report pass/fail
using various mechanisms, i.e., 271 response to 270, 277 response to
276,
and so on.

But that's just one person's viewpoint.

Rachel
Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
Professionals in EDI & Electronic Commerce
39432 North Avenue
Beach Park, IL 60099
Phone: 847-872-8070
Fax: 847-872-6860
http://www.rfa-edi.com
-----Original Message-----
From: Jim Moores [mailto:[EMAIL PROTECTED]]
Sent: Monday, April 15, 2002 7:55 AM
To: [EMAIL PROTECTED]
Subject: RE: questions on the appropriate way to reply when there
areerrors
in a transaction request





Hi Rachel,

  I agree.  However, do you just reject the one claim in error or do you
just reject the entire batch of claims in the transmission (assuming
that
you have gotten other transactions in the transmission)  or do you
reject
the entire transmission?  In some cases, I think that the entire
transmission is appropriate... like when the loop structure is so
corrupt
that you can't parse it.  But, what about the area between that and the
perfect transmission?



Jim Moores - HIPAA Team Leader - Privacy
Antares Management Solutions
23700 Commerce Park Road
Beachwood, Ohio   44122-5832

[EMAIL PROTECTED]
Phone: (216)292-1605
Fax:      (216)292-1619


>>> [EMAIL PROTECTED] 04/13/02 08:30PM >>>
Connie,

If the incoming transactions contains X12 standards syntax errors it
must be
rejected. The correct way to report this rejection is via the 997
Functional
Acknowledgment transaction.

Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
Professionals in EDI & Electronic Commerce
39432 North Avenue
Beach Park, IL 60099
Phone: 847-872-8070
Fax: 847-872-6860
http:/www.rfa-edi.com


-----Original Message-----
From: Connie Lagneaux [mailto:[EMAIL PROTECTED]]
Sent: Friday, April 12, 2002 1:06 PM
To: '[EMAIL PROTECTED]'
Subject: questions on the appropriate way to reply when there are errors
in a transaction request



1. If there are actual syntax errors in an incoming X12, what exactly is
the
correct way to respond? By this I mean it is not a valid X12 at all.
We
are unclear as to whether it is appropriate to respond with a 997 vs
something, for example, in a 271 or 277).

2. If there are "logical" errors in an incoming X12, what exactly is the
correct response? By this I mean it is a valid X12 but it does not meet
the
HiPAA specs.
Examples:
If 276 - IG 54, 98 - is not set to the code "PR" for payor but to
something
else, what do we do? (if we would be receiving requests only from
payors)  A
997 response?
If 276 - IG 67, 98 - is not set to "1P" for provider but to something
else,
what do we do?  (if we are only expecting 1P) A 997?

3. If there are "business" errors in an incoming X12, what exactly is
our
response? By this I mean that the request is both a valid X12 and a
valid
HIPAA transaction but contains other errors.
Examples would be an unknown information source (payor), and unknown
provider, etc. Also I think this would include issues like the dependent
given is not a dependent of the given subscriber.

It appears that each level of a 271 has request validation segments /
reject
reason codes in the 270 request.  Are these codes used for business
errors
while a 997 is used for other errors? Since the 277 lacks these codes,
are
all errors handled using 997s? If so doesn't this stop all further
processing of the 276 transactions in the transmissions?


<<...OLE_Obj...>>
        Connie Lagneaux, RN, BSN, MBA
Senior Business Analyst
5151 E. Broadway Boulevard, suite 1050
Tucson, AZ  85711

Phone (520) 571-1988 ext. 153
Fax     (520) 571-1927
<mailto:[EMAIL PROTECTED]>





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