Dana,
The HIPAA transaction rules dictate that for DDE systems they must comply with the
data content of the transaction set. The HIPAA transaction rules also state that DDE
cannot offer additional functions availible in the transaction set, but not supported
by users of the X12 transaction. You are not mandated to support the EQ02 procedure
code functionality in the 270 Eligibility transaction, so you would not have to
support it through your DDE. Even if you do support the use of EQ02 in the 270
Eligibility transaction, you are not mandated to support it through DDE.
In general terms, so long as your DDE system has equal or less functionality
(including response time) than those available to providers using the X12 transaction
you will be fine. It's when you offer more functionality through DDE than the X12
transaction (including response time) that you will have compliance problems.
Stuart Beaton
Vice President
Washington Publishing Company
Co-Chair X12N/TG2/WG1 - Health Care Eligibility
-----Original Message-----
From: Grant, Dana [mailto:[EMAIL PROTECTED]]
Sent: Fri 5/17/2002 9:10 AM
To: '[EMAIL PROTECTED]'
Cc: Campese, Mary Frances; Fullmer, Natalie
Subject: DDE 270/271 EQ01/EQ02
For the 270/271 Health Care Eligibility Benefit Inquiry and Response
Transaction set, within the EQ segment in the 270 Inquiry, either
EQ01-Service Type Code or EQ02-Composite Medical Procedure Identifier must
be used. Only EQ01 or EQ02 is to be sent, not both. Can a health plan's DDE
system support only EQ01-Service Type Codes or must it support both
EQ01-Service Type Codes and EQ02-Composite Medical Procedure Identifier?
I appreciate any feedback that may be provided and would be interested in
hearing from other health plans using DDE for the 270/271.
Thanks for your time.
Dana Grant
Business Analyst/HIPAA-EDI
Coventry Health Care
E-mail: <Mailto:[EMAIL PROTECTED]>
Phone: 724-778-3782
Fax: 724-778-4284
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