It's extremely important to read the actual language of the Electronic
Transaction Final Rule to understand what's required, and what's permitted
under what conditions.

For many of the transactions, the final rule is quite explicit in
identifying what entity type the transaction is originating from and to what
entity type it's destined. For other transactions, no such specificity
exists, or the rule says that the transaction is from any entity to a health
plan.

The DDE exception is just that -- an exception -- for the **provider** to a
health plan. Under the DDE exception the format requirements are removed,
but the data content requirements remain. The DDE exception is not concerned
with whether the DDE mechanism is the old CICS, web browser, or what. But,
what the HHS FAQs clearly indicate, is that neither fax or IVR is either
considered a DDE exception or an electronic transaction. Thus both of these
message exchange modes are not covered under the electronic transaction
final rule.

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: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Thursday, May 02, 2002 5:33 PM
To: [EMAIL PROTECTED]
Subject: RE: Voice Response Systems


Ok, so in reading these two sections, does that mean HTML still must
conform?  If the format is XML, playing semantics, would it be exempt
because it is not expressly identified?  What about a closed system where
the data is NOT for billing purposes at all?

I'm in the process of spec'ing a system for a New England Public Health
Department that would be impacted by this.  Of course, privacy and security
are being built-in, however, since it is a closed system, not transactional
considerations were given thus far.

TMc

-----Original Message-----
From: Mosesso, Laura [mailto:[EMAIL PROTECTED]]
Sent: Thursday, May 02, 2002 4:53 PM
To: [EMAIL PROTECTED]
Subject: TCS: Voice Response Systems


> I am in search of clarification regarding Voice Response System
> requirements under the TCS rule.
>
> Page 50315 of the 8/17/00 Federal Registrar states that telephone voice
> response [systems] must conform to the data content portion of the
> standard, but not the format.
>
>       "Certain technologies present a special case for the use of standard
> transactions. We proposed that telephone voice response, ''faxback'', and
> Hyper Text Markup Language (HTML) interactions would not be required to
> follow the standard. We have since reevaluated this position in light of
> the many comments on this position and on developments in the EDI industry
> which continue to expand the options in this area. We have decided that,
> instead of creating an exception for these transmissions, we will
> recognize that there are certain transmission modes in which use of the
> format portion of the standard is inappropriate. However, the transaction
> must conform to the data content portion of the standard."
>
> But a 12/28/00 DHHS FAQ response states:
>       "Fax imaging and voice response transmissions are not subject to the
> HIPAA transactions standards but may have to meet privacy and security
> standards. Health plans may continue to offer these services, however,
> they must still be able to accept and send the HIPAA standard
> transactions."
> And the Medicare Managed Care FAQ's posted 3/26/02 states:
>       "Voice response or fax systems do not have to meet the data content
> requirements of the HIPAA standard."
>
> Can someone help clarify this seemingly conflicting information?
>
> Your feedback is appreciated.
>
> Laura A. Mosesso
> Coventry Health Care
> HIPAA/EDI Compliance Manager
> Email:  [EMAIL PROTECTED]
>
>
>
>


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