Rachel,

The statement I used that stated "Proving that application systems meet the
new HIPAA business requirements..." was just a generic statement in lieu of
writing a longer description and lengthier e-mail. What I meant by that
statement was exactly what you wrote below without going into the
description. Thank you for the clarification, I will make it a point to go
into further detail when something could be construed as ambiguous or
misunderstood.
In regards to your statement "an entity only needs to demonstrate that it
can generate a complying transaction or receive a complying transaction." ,
the HIPAA test cases and conditions still need to prove that new and
regression business functionality is not impacted. This cannot be done by
just proving the ability to send or receive a properly formatted file. Many
CE's are struggling with creating the test cases to resemble existing and
anticipated lines of business because they are either starting from an
unknown (creating a test file using an EDI tool along with their
interpretation of the (IG) and/or finishing with an unknown. i.e. - if the
file passed or failed, did the test analyst map the test file properly or
worse did they even know what the expected results were supposed to look
like?). Also the process is going through several layers of translation, the
analyst to the test file and then through the translator or middleware
component most likely mapped by another analyst. This just scratches the
surface but to me, there are just too many variables and not enough
traceability when trying to conduct a proper test effort and correcting
possible defects. The effect of this will lengthen test phases, test case
preparation, testing timelines, and defect tracking and resolution to the
point that deliverables will be late, implementation dates missed and mostly
certainly a negative impact on already thin budgets. With a more quality
assurance centric plan, CE's may avoid some of these pitfalls along the way,
otherwise the 3rd and 4th quarters of 2003 will not be a pleasant experience
for many CE's.
Mark A Lott
President
HIPAA Testing, Inc.

www.hipaatesting.com
Office: 480-946-7200
Cell:   480-580-4415
Fax:  877-825-8309

"Advanced Testing and Certification of HIPAA Transaction Compliance"
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-----Original Message-----
From:   Rachel Foerster [mailto:[EMAIL PROTECTED]]
Sent:   Tuesday, July 16, 2002 1:14 PM
To:     [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject:        RE: Testing for levels 3, 4, and 6

Mark,
As an EDI and IT professional I agree with much of what you say below.
However, there is one point that I disagree with...it's your statement that
"Proving that application systems meet the new HIPAA business
requirements..." is a HIPAA requirement. Actually, it's not....all that the
law requires is that the transaction conform to the standard data content
and the standard format, which is based on the X12 standards. What the
internal apps do is irrelevant in terms of whether they have been
remediated, replaced, or whatever. I don't mean to imply that backend apps
must at some point either be remediated or replaced, but that is not a
requirement of HIPAA.

Thus, in order to "prove" compliance with the HIPAA Electronic Transactions
Final Rule requirements, an entity only needs to demonstrate that it can
generate a complying transaction or receive a complying transaction. Once
that's been proven, the internal processing of the transaction data can be
totally manual or semi-automated or totally automated. The law doesn't care.
Of course, manual or semi-automated internal processing doesn't get one to
administrative simplification, does it? But the law does NOT mandate that
any covered entity redesign their internal business processes for cost
reductions and/or simplification. Those of us that have been in the EDI game
for a few decades know that just implementing an EDI capability doesn't
create any business benefit UNLESS the internal business processes are
redesigned as well.

Re your comment about machine readable IGs - what a concept. This capability
has existed for several years using the UN/EDIFACT IMPDEF message
specification. IMPDEF was developed cooperatively between the UN/CEFACT and
the X12 Committee and its specifically intended to be able to convey in
machine readable syntax based on the international standard for EDI, which
all good commercial translators should be able to process, an organization's
implementation definition for any X12 transaction set or UN/EDIFACT message.
Personally, my opinion is that it's a major shame that the HIPAA
implementation guide specifications were made available ONLY in the Adobe
.pdf format and not ALSO in the IMPDEF format for automated processing. Oh
well......

BTW, a colleague of mine already has the HIPAA 270, 820, 834 and 835 ICs and
a portion of the 837D in IMPDEF form.

Rachel
Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
Professionals in EDI & Electronic Commerce
39432 North Avenue
Beach Park, IL 60099
Phone: 847-872-8070
Fax: 847-872-6860
http://www.rfa-edi.com




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