The eleigibily inquiry you mentioned directly into a payer's system sounds like a DDE transaction. If the web page is the plan's, then it would also be DDE.
Stanley Nachimson HIPAA Project Team, CMS 410-786-6153 >>> Stephen Block <[EMAIL PROTECTED]> 05/30/02 09:23AM >>> I think this requires further clarification. Is an inquiry for eligibility made directly into a payer's system (through the Web or otherwise) considered an EDI transaction? Is it EDI if the same inquiry is built on a web page if the web page is sponsored by the plan? I was under the impression that the 270/271 transactions are intended for system-to-system inquiries. I definitely could be mistaken. Stephen C. Block Director, Information Services St. Joseph's Hospital Health Center 301 Prospect Ave. Syracuse, NY 13203 (315)-448-5613 (phone) (315)-448-5424 (fax) -----Original Message----- From: Stanley Nachimson [mailto:[EMAIL PROTECTED]] Sent: Thursday, May 30, 2002 8:32 AM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Re: Internet Transaction limitations? Your understanding is not entirely correct. The requirements for web/Internet transactions depends on whether they are a Direct Data Entry transaction (ie a provider entering data directly into a plan's system via a web page) or a transaction built on a web page and then sent via the Internet to the plan. If the former, then the transaction must be compliant with data content and coding requirements of the standards; no proprietary coding. Additional functions can be made available via optional screens; but providers cannot be required to use these to complete a transaction. If the latter situation exists, then the transaction must be both data content and format compliant. Stanley Nachimson HIPAA Project Team, CMS 410-786-6153 >>> <[EMAIL PROTECTED]> 05/29/02 07:28PM >>> Am I correct that web/Internet based transactions do not have to comply with the format of the standard transaction (ANSI) but the content with respect to the code sets must comply? For example, when a provider inquires about a patient's eligibility/benefits via the Internet, may I respond with information which is from our proprietary system (such as member ID suffix)? May we send back via the screen information and fields which is not contained in the ANSI transaction, or are we limited to the scope of that transaction, even if the format is not required to be compliant? Thank you, ================================= Margaret Shilling Manager, Trading Partners The Regence Group Phone: 253.573.3407 Email: [EMAIL PROTECTED] =========================================================================== IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should delete this message and are hereby notified that any disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.
