RE: Compliance with x12 vs. HIPAA IG

[Rachel Foerster]

Title: RE: questions on the appropriate way to reply when there are error in a transaction request

David,   Irrespective of any state's prompt payment acts, the federal law prohibits any covered entity from conducting a transaction covered by the law that does not comply with the standard specification. Further, the HIPAA Electronic Transaction Final Rule specifically supercedes any state law to the contrary unless the state law is necessary to prevent fraud and abuse.   Again, making the decision to conduct one of the transactions covered by the law that is not compliant with the standard required by the law opens up the organization to the assessment of the penalties set forth in the law. It's still a business decision to assume the risk of not complying with the law.   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: David Frenkel [mailto:[EMAIL PROTECTED]] Sent: Wednesday, April 24, 2002 10:52 AM To: [EMAIL PROTECTED] Subject: RE: Compliance with x12 vs. HIPAA IG Joe, The letter of the law says the transaction must be HIPAA compliant or it is rejected.  I would think you would have to use some judgement though.  If you get a lot of claims that have �extraneous� information you might process them and follow-up with the provider as time allows.  If you are like most state agencies you might not have the resources to reject a lot of claims and subsequent phone calls.  I worked for another State HHS and we came under political pressure to get claims paid on a timely basis before there were prompt pay laws.  I imagine you have the same issues.   Regards,   David Frenkel Business Development GEFEG USA Global Leader in Ecommerce Tools www.gefeg.com 425-260-5030 -----Original Message----- From: Barton, Joe [mailto:[EMAIL PROTECTED]] Sent: Tuesday, April 23, 2002 4:16 PM To: '[EMAIL PROTECTED]' Subject: RE: Compliance with x12 vs. HIPAA IG   Rachel. So if we get a segment that does not related to any business of ours, such as one that is optional, or even still, one that does not related to a waivered service claim, we reject the whole claim even if everything required to process