I am clear on that aspect. Thank you. Perhaps the questions would have
been better posed directly to our business partners. However, if any of
you know what Medicaid and Medicare are requiring, that would be helpful.
Alice
"David Frenkel"
<frenkel@worldne To: <[EMAIL PROTECTED]>
t.att.net> cc:
Subject: RE: Transaction certification
- vendor software and
05/07/2002 12:19 clearinghouses
PM
Alice,
Just to clarify a few comments you made. There is no 'certification'
required under HIPAA. The certification you are referring to is
Claredi's certification. Some payers are requiring it to do business
but it is strictly a business decision and is not part of the HIPAA
regulations.
Regards,
David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
425-260-5030
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, May 07, 2002 9:03 AM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Transaction certification - vendor software and clearinghouses
I am heading up the HIPAA transactions compliance project at my hospital
and I have a couple of questions for you. As a background, we submit
claims to Medicare, Medicaid, Trigon of Virginia, and the remainder
through
various clearinghouses. Trigon and Medicare are using Claredi as their
certification service. Trigon sent us a letter recently stating that we
much certify in order to continue doing business with them. Medicare
requires the same.
One question I believe was covered at the HIPAA Summit in DC recently,
but
I would like a more detailed response: If we use vendor code which has
been certified compliant, do we as a healthcare provider also have to
certify that our transactions are compliant. I believe the answer is
"yes"
but I would like reasons that I can take back to justify the time and
expense. It is understood that business to business testing would be
required.
On the same note, if the clearinghouses have been certified do we have
to
certify our transactions or merely test with the clearinghouses? If so,
please justify that for me. I had thought that the Summit dialog
supported
a "no" response to this question, but in the Claredi documentation it
appears that we would be expected to certify our transactions coming out
of
the clearinghouse.
Thank you,
Alice L. Davis, CISA, CISSP
Information Security Manager - VCU Health Systems
Richmond, VA (804) 628-1144
