Of course trading partner specific stuff is legal....this is where much of
the situational items are defined. The only prohibition is that any trading
partner specific stuff not violate any of the HIPAA specifications.

It's the trading partner specific stuff (most often from the payer) that
results in companion documents which give guidance to the providers such
that when they submit a HIPAA compliant claim it can pass through the
payer's adjudication system as cleanly as possible. After all, the goal is
not to send a HIPAA complaint claim, the goal is to get paid!

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



-----Original Message-----
From: William J. Kammerer [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, July 16, 2002 9:07 PM
To: [EMAIL PROTECTED]
Subject: Re: Testing for levels 3, 4, and 6


Chris:

Can we take this discussion to one or the other of the WEDI/SNIP mailing
lists, in order to avoid cross-posting?  I suggest "Transactions,"
simply because discussion may uncover bigger issues than simply testing.

Having said that, I'm sure the various purveyors of HIPAA validation
tools and services must have the HIPAA IGs in some machine readable
format, replete with business rules and access to standard code sets.
Otherwise, they wouldn't be able to do HIPAA compliance testing (unless
they had really lousy programmers who hard coded everything in their
application code!!). So the stuff (machine readable IGs) obviously
exists - though the vendors may treat these materials as valuable
intellectual property, considering a lot of business knowledge is tied
up in them. And once an IG has been codified in some interoperable
standard, like SEF, it is not rocket science to produce an IMPDEF
version (or vice versa).

But I really want to know just what the heck anyone else (besides
testing or translator vendors) would want with machine readable HIPAA
IGs?  Why would a payer or provider want to promulgate her own "subsets"
of the HIPAA IGs?  What kind of trading partner specific junk would you
expect to see in one of these?  Is trading-partner specific stuff even
legal under HIPAA?

William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320

----- Original Message -----
From: "Christopher J. Feahr, OD" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>
Sent: Tuesday, 16 July, 2002 09:16 PM
Subject: RE: Testing for levels 3, 4, and 6


Rachel,
I have a few questions about this...

- What sort of labor is required to convert the plain text version of an
X12 IG into the IMPDEF format?
- How is the logic represented... SQL statements?
- Do commercial translators reliably read IMPDEF documents today?
- Are there other approaches to "machine-readable IGs" in reasonably
wide use besides IMPDEF?
- Will the  XML versions of the standards eventually  render some of
this moot?

Since we would only be talking about a different presentation format, it
would seem that X12 IGs could be translated to IMPDEF without any
specific HHS authorization... right?

(I'm sure there must be a slew of problems with doing this... or we
would have done it.  Where is the current discussion taking place within
X12?)

Thanks,
Chris

At 03:14 PM 7/16/2002 -0500, Rachel Foerster wrote:
>BTW, a colleague of mine already has the HIPAA 270, 820, 834 and 835
ICs and
>a portion of the 837D in IMPDEF form.

Christopher J. Feahr, OD
http://visiondatastandard.org
[EMAIL PROTECTED]
Cell/Pager: 707-529-2268




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not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP.  If 
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Database at http://snip.wedi.org/tracking/.
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