-------- Cross posted to the WEDI SNIP Routing Subworkgroup List ------- Pat, this isn't a dumb question at all - it's actually probably one of the more intractable problems that needs to be solved before we can enable frictionless e-commerce hailing in the age of Administrative Simplification.
You hit the nail on the head: practically everyone knows where the payers are, but finding the providers in turn is more of a mystery. Clearinghouses freely advertise the payers they have connectivity to: it's a draw for the masses of providers who will sign up with a clearinghouse. On the other hand, a Clearinghouse would probably never advertise the providers on its network - this "directory" is the proprietary family jewels of the CH (and to be fair, VANs behave the same way). In short, until an automated registry of electronic partner profiles is available, each provider will have to supply to the payer her electronic "address," including her ISA receiver (mailbox) ID and the clearinghouse she uses. WEDI/SNIP Business Issues has a Special Interest Group (SIG) investigating this issue, trying (still!) to develop recommendations for identification and routing. Your question is more appropriate for the ID & Routing group listserve rather than the Testing listserve. Please go to http://subscribe.wedi.org/ and subscribe to the WEDI SNIP Routing Subworkgroup List and we can continue the dialog. Archives for the ID & Routing mailing list reside at http://www.mail-archive.com/wedi-routing%40lists.wedi.org/; older archives (before WEDI switched over to the new listserves) are at http://www.mail-archive.com/routing%40wedi.org/. William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ----- Original Message ----- From: "Pat Shannon" <[EMAIL PROTECTED]> To: "WEDI SNIP Testing Subworkgroup List" <[EMAIL PROTECTED]> Sent: Tuesday, 04 March, 2003 09:15 AM Subject: This is probably dumb, but here goes anyway Please excuse this intrusion, but I really want to know. I run a rather large billing center and monitor the list serves to keep current on EDI issues. I have learned a great deal and understand the transactions just fine, but am missing a piece of the puzzle when it comes to transactions aimed at physicians, especially unsolicited transactions. Everybody knows where the insurance companies are and how to get to them. How does a transaction get to a physician if it is not a response transaction taking the same path as the original transaction. Is their some master address file that says to get to physician 12345 that you sent to clearinghouse abc ???? and if you change clearinghouses, how does this get updated ??? Thinking in terms of a physician wanting to send a 278 to refer a patient to another physician, how would that transaction get routed and find its way to the other physician. Or if we require an HMO to provide our physicians with monthly unsolicited 271 roster updates, how would they get to us ??? I would be grateful if someone could spare a moment to educate me. Thanks Pat
smime.p7s
Description: S/MIME cryptographic signature
--- 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/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-testing as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
