I'm not any more in favor of killing functioning systems than the next guy... particularly when the "legal" processes that providers would have to fall back on (e.g., phone inquiries) might be even less efficient than DDE. But folks... this is why we have decided to hold our collective feet to the fire with Transaction Rule and hard deadlines. I might even "vote" for allowing payors with mature, feature-rich DDE services some additional deadline relief, if there was good-faith effort toward creating a system that looked/functioned the same [from the provider's perspective] for all payers... and could be AUTOMATED in my practice management system... the same way for ALL payers.
Allowing DDE systems to remain in place for any reason, would be very bad for providers. Small providers would essentially be "sentenced without parole" to non-standard, manual processes and the incentives for their software vendors to tackle "small system EDI" would completely evaporate. Doctors might "accept" this because, after all, what choice would they have?
We should stick to our guns and try to do this just like it says in the Transaction rule.
Regards,
-Chris
Christopher J. Feahr, OD
Optiserv Consulting
[For the vision care industry]
Santa Rosa, CA
707-579-4984
707-529-2268 (cell/pager)
http://VisionDataStandard.org
http://Optiserv.com
At 11:02 AM 10/21/2002 -0500, Mimi Hart wrote:
My opinion only...
As a provider, I usually take the line that any system that is
proprietary only to a certain payer, and requires my staff to go
"outside" their system and data enter/key to look up a patient, is not
in our best interest. BUT, I also live in the real world, and as I have
learned over the last 6 months, eligibility and claim status inquiry
ability on many of my 30+ applications is going to be along time
coming....
So what good is shutting down a system that gives us useful, timely
information, in favor of a system that I can't take advantage of because
my applications are not electronic transaction ready?
Mimi Hart ӿ�*
Research Analyst, HIPAA
Iowa Health System
319-369-7767 (phone)
319-369-8365 (fax)
319-490-0637 (pager)
[EMAIL PROTECTED]
>>> [EMAIL PROTECTED] 10/21/02 10:08AM >>>
I'm not opposed to keeping the old system, provided it meets the
minimum standards for HIPAA compliance. This system sends PHI
over the internet in clear text. I have a problem with that. It's
also my
responsibility to make sure we don't put our organization at risk by
knowingly using a solution that is blatantly non-compliant, whether it
be EDI content or privacy. It would be very hard for me to justify to
the CEO why we are being fined for knowingly using a non-compliant
solution, personally, I enjoy getting a regular paycheck and take a
very conservative view about activities that might endanger the
continued reception. 8^)
This is just one issue of several going on between the medicare
contractors in our state and the DHS offices, not an isolated item.
I thank everyone for the feedback I've gotten so far.
> Why are you so opposed to this?
> Keeping the old system indefinetely does not preclude a parallel,
> HIPAA compliant feature. Why do you insist on replacing a working,
> mature system with unproven technology. As long as routing and
> transport mechanisms for EDI are not standardized through HIPAA, it
> will be even dangerous and irresponsible to to "replace" and shut
down
> a working technology that plays an important part in the delivery of
> healthcare. Implicitly demanding the shut-down of a perfectly fine,
> working system because of HIPAA seems terribly dogmatic. I just saw
> the online system of Blue Cross of Alabama. It's a marvel and works
> impressively for eligibility, claims, status, authorizations and so
> on. The system is matured and through code tied into the systems of
> all major providers. People dread the thought of turning it off
just
> to please the letter of the law. BC of AL should seriously consider
to
> keep the system running until electronic exchange according HIPAA is
> proven, (for several years in all practicality). I think trading
> partner agreements that extend TPO status across to the consumers of
> these legacy services will satisfy the intent of the law if not the
> letter.
>
> Martin Scholl
> <mailto:mscholl@;martinscholl.com>
> <http://www.martinscholl.com>
> 301-924-5537 Voice
> 301-570-0139 Fax
> 301-613-9572 Cell
>
>
> -----Original Message-----
> From: Del Texley [mailto:dtexley@;lipa.net]
> Sent: Thursday, October 17, 2002 1:03 PM
> To: [EMAIL PROTECTED]
> Subject: State Online system
>
>
>
> Our state has an online system to look at eligibility and
> claims/encouter data. It's just a mainframe/telnet session via
> dialup, leased line or internet.
>
> At a meeting yesterday we were given information about some minor
> changes to the system and of course it was asked what would be
> replacing it for HIPAA compliance. Imagine our surprise when the
> state informed us the system would continue in it's current form
> indefinately.
>
> When quizzed about HIPAA issues we were told the Dept. of Justice
had
> determined that the system was "not DDE" because "no claims data was
> input via the system" and was not performing HIPAA transactions
> because "no files were being transferred" and was therefore exempt
> from HIPAA.
>
> The stand of the contractors in the meeting was that regardless of
> whether the system was or wasn't DDE (which it is), the system was
> transmitting PHI in an electronic format and therefore was required
to
> adhere to privacy requirements, such as encryption of the data.
>
> I'm gathering information to send to the contact person as part of a
> request to revisit the classification of this system. Anybody have
> some suggestions on documentation sources or comments on the
> situation?
>
> Thanks
>
Del Texley
LIPA Information Systems
(541) 484 6430
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