I hear what you're saying about providers not having to have X12 expertise in order to understand the impact of the HIPAA TCS rule on their business. However, the X12N Implementation Guides are no longer only syntactical guidelines -- they actually establish business rules for when elements are required. The billing managers in the "average provider" site NEED to see these requirements -- it is not enough for just their vendor to understand them. The vendor can take care of the formatting and balancing, but the business requirements of the transactions actually impact the business decisions made to capture and submit the appropriate data content for reimbursement. This is a big departure from the way data content requirements have been communicated in the past, but it is the reality of HIPAA.
The data content gap analysis must include those who make the everyday decisions about what data is captured for the HIPAA transactions. In most cases, they are already knowledgeable about the data content required for claims. They just need to understand the HIPAA business data requirements that are only described in the IG's. Larry -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] Sent: Tuesday, October 15, 2002 2:32 PM To: [EMAIL PROTECTED] Subject: RE: Missing Elements on an HCFA 1500 I couldn't even begin to guess what an average provider is in health care, but let's take the case of providers that do not have IT departments and use systems purchased from and supported by a vendor. That provider needs to determine which HIPAA transactions they perform electronically. >From there, they need to negotiate with the vendor for the changes necessary to meet HIPAA requirements. The vendors that plan to be in business two years from now will make this as painless as possible for their clients. I cannot imagine the scenario that would send this "average provider" looking through an implementation guide. They will need to educate themselves enough to determine the credibility and reliability of the vendor, but that should not require X12 expertise. Hope this helps, Susan Miller [EMAIL PROTECTED] ********************************************************************** 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.
