RE: Certification

[Larry Watkins]

Kris makes a very important differentiation.  It is the 'ability to create a standard transaction' that is certified.  This 'ability' is very important.  It is also important to know what specific 'capabilities' within the 'ability' have been demonstrated to a certification system.  This is because there are so many permutations of compliant transactions within the complex health care environment.  Remember that systems or applications that have the 'ability' to generate HIPAA compliant transactions could also be used to create non-compliant transactions -- there is simply no way around this.    So, here's an attempt at a sequence of this:    1.  The 'ability' of an application or system (direct or clearinghouse) is certified to a detailed level.  This certification is useful for covered entities to know which application/system to use or buy.  (It may or may not be necessary depending on whether such a decision is being made.) 2.  The application/system is then implemented by/for a covered entity.  3.  Then, the covered entity gets their own transactions certified (direct or clearinghouse) to a detailed level to determine that the application/system was implemented successfully.  Again, it is the 'ability' of the covered entity to create HIPAA compliant transactions using a specific application/system that is certified.  And it is important that the specific 'capabilities' of the 'ability' be certified, so the covered entity can be sure they are generating HIPAA compliant transactions for all of the applicable permutations (e.g., for institutional claims: Inpatient, Outpatient, Rehabilitation, Mental Health, etc.; for professional claims: Office Visit, Anesthesia, DME, Oxygen, etc.).   Hope this helps, Larry   -----Original Message----- From: Owens, Kris [mailto:[EMAIL PROTECTED]] Sent: Wednesday, April 17, 2002 1:25 PM To: '[EMAIL PROTECTED]' Subject: RE: Certification Rachel,   Your point is well taken and absolutely correct.  However, I maintain, at least in our case we are not certifying the software or the vendor, we are certifying our organization's ability to create a standard transaction - by whatever means.   Kris Owens  505/923-8108 "You don't know what you can get away with until you try"  General Colin Powell   -----Original Message----- From: Rachel Foerster [mailto:[EMAIL PROTECTED]] Sent: Wednesday, April 17, 2002 10:41 AM To: [EMAIL PROTECTED] Subject: RE: Certification However,   The application system (a claims processing system, for example) must be able to capture, store and make available all of the data required in any given HIPAA transaction. Another piece of software, whether an EDI management system, or a clearinghouse or billing service cannot conjure up data that the application system doesn't serve up.   So, first the data....then the format. Formatting without the required data is just junk.   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: Owens, Kris [mailto:[EMAIL PROTECTED]] Sent: Wednesday, April 17, 2002 8:46 AM To: '[EMAIL PROTECTED]' Subject: RE: Certification Let me spin it one more way.  When we talk about certification we are talking about the transactions we produce, using multiple pieces of software, our applications systems to extract data and our translator to format the data.  I don't see this as certifying either of those pieces of software, but rather as you refer to in your message, certifying the ability to create a transaction that complies with the HIPAA standard.  Our software cannot produce standard transactions, and our vendor has no plans of modifying their software to do so.  They are not a covered entity and they believe that it becomes the CE's responsibility to produce the transaction - not the vendor's software which is sold as a claims processing system, not a HIPAA standard transaction producing system.   Kris Owens 923-8108 "You don't know what you can get away with until you try"  General Colin Powell ********************************************************************** 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. ===================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.