Janie, Health Plans are required to accept the 834 Transaction if an employer wants to submit enrollment using the HIPAA EDI Transaction. The following is from the final rule for Transaction Sets:
� 162.925 Additional requirements for health plans. (a) General rules. (1) If an entity requests a health plan to conduct a transaction as a standard transaction, the health plan must do so. (2) A health plan may not delay or reject a transaction, or attempt to adversely affect the other entity or the transaction, because the transaction is a standard transaction. (3) A health plan may not reject a standard transaction on the basis that it contains data elements not needed or used by the health plan (for example, coordination of benefits information). (4) A health plan may not offer an incentive for a health care provider to Director of the Office of the Federal Register approves the implementation conduct a transaction covered by this part as a transaction described under the exception provided for in � 162.923(b). Please feel free to contact me if you have any additional questions regarding my response. I have an EDI background and have coded the 834 for employers and health plans. Hope Hope Furtado Corporate Information Architect TM Floyd & Company, Inc. [EMAIL PROTECTED] (800)780-1170 extension 129 (803)765-1310 extension 129 > -----Original Message----- > From: Janie Miller [SMTP:[EMAIL PROTECTED]] > Sent: Thursday, July 11, 2002 6:39 PM > To: '[EMAIL PROTECTED]' > Subject: RE: req vs. situation - companion documents > > I work for a vendor providing payer solutions. One of our clients has > stipulated this as one of their business requirements within an 834. I > just > wanted to be sure to understand the legal side of it. > > -----Original Message----- > From: David Frenkel [mailto:[EMAIL PROTECTED]] > Sent: Thursday, July 11, 2002 3:23 PM > To: [EMAIL PROTECTED] > Subject: RE: req vs. situation - companion documents > > > Janie, > You don't have to mention names but has somebody asked you use 'NOT > Used' fields? > > Regards, > > David Frenkel > Business Development > GEFEG USA > Global Leader in Ecommerce Tools > www.gefeg.com > 425-260-5030 > > -----Original Message----- > From: Janie Miller [mailto:[EMAIL PROTECTED]] > Sent: Thursday, July 11, 2002 1:02 PM > To: '[EMAIL PROTECTED]' > Subject: req vs. situation - companion documents > > Probably ignorant questions, but I must clarify for my own sanity: > > In a companion document, is it HIPAA compliant for a covered entity to > "require" certain "situational" loops/segments/data elements of its > trading > partner(s)? What about when the covered entity wants to "require" > certain > specific data in "NOT USED" description fields? > > > > ********************************************************************** > To be removed from this list, send a message to: > [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request. > > ====================================================== > The WEDI SNIP listserv to which you are subscribed is not moderated. > The discussions on this listserv therefore represent the views of the > individual participants, and do not necessarily represent the views of > the WEDI Board of Directors nor WEDI SNIP. 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If you wish to receive an official opinion, > post your question to the WEDI SNIP Issues Database at > http://snip.wedi.org/tracking/. > Posting of advertisements or other commercial use of this listserv is > specifically prohibited. > > > ********************************************************************** > To be removed from this list, send a message to: > [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request. > > ====================================================== > The WEDI SNIP listserv to which you are subscribed is not moderated. The > discussions on this listserv therefore represent the views of the > individual participants, and do not necessarily represent the views of the > WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official > opinion, post your question to the WEDI SNIP Issues Database at > http://snip.wedi.org/tracking/. > Posting of advertisements or other commercial use of this listserv is > specifically prohibited. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. =====================================================The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
