These are the types of questions we wrestle with in the Joint WEDI/SNIP and AFEHCT ID & Routing Special Interest Group. If you're interested in helping us solve problems of identifiers as used in routing interchanges, please join the WEDI/SNIP ID & Routing group by going to http://snip.wedi.org/listserv/ and signing up for "Routing." Postings are sent to the mailing list at [EMAIL PROTECTED] Project documents and archives of the [EMAIL PROTECTED] mailing list are available at the WEDI/SNIP ID & Routing Group Web page at http://www.novannet.com/wedi/.
Of course, the ISA, GS and NM1 identifiers are only the tip of the iceberg. Ultimately, our work will result in recommendations for the "auto-discovery" of trading partners (payers, providers, third-party administrators, etc.) and their technical capabilities. Borrowing from ebXML, we will devise an XML schema for a Healthcare Collaboration-Protocol Profile (CPP) - basically an electronic Trading Partner Profile. CPPs will be located by Trading Partner ID of any participant involved in HIPAA Healthcare EDI, through the OASIS ebXML Registry. In summary, the ISA sender always reflects the ID of the entity which slapped the interchange together, and more importantly, who expects the TA1 and 997 acknowledgements. So ISA05/06 would indeed be the ID (and ID domain qualifier) of the Clearinghouse, as the CH is the one expecting acknowledgements. The 1000A Loop is kind of loosey-goosey; see Jan Root's comments in "837 Professional - Electronic Transmitter Identification Number (ETIN)," from 28 Mar 2002, at http://www.mail-archive.com/[email protected]/msg00753.html. William J. Kammerer Co-Chair, WEDI/SNIP Business Issues ID & Routing SIG Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ----- Original Message ----- From: "Janet Jackson" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, 29 May, 2002 02:09 PM Subject: 837 - Sender, Submitter and Provider IDs I have a basic question about the sender/submitter/providers in the 837. Scenario: Clearinghouse submits claims for ABC Provider to EDF Insurance Company. Please confirm who is identified where in the 837, when there is a clearinghouse involved... ISA - ISA05/06 - Sender ID = Clearinghouse ID information ISA07/08 - Receiver ID = EDF Insurance Company info ST - Loop 1000A, NM108/109 = ABC Provider information OR is this still the clearinghouse information? Loop 2010AA, NM108/109 and REF01/02 - ABC Provider info. Thanks in advance for your time and response. Janet Jackson Project Manager, EDI Development (919) 765-3073 (919) 765-7101 (fax) [EMAIL PROTECTED] Blue Cross Blue Shield of North Carolina Innovative health care designed around you.
