Marsha, what you say makes sense. I withdraw the comment about costs.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Sent: Wednesday, May 28, 2003 7:57 PM
To: WEDI SNIP Testing Subworkgroup List
Cc: WEDI SNIP Testing Subworkgroup List
Subject: RE: Meeting Minutes - 5/22/2003 -- comments
Hi,
I do not think that our answer on the Testing issue should include any
reference to costs or responsibility for those costs.
First because the person submitting the inquiry did not ask for
information about absorbing any costs. I don't think SNIP should
volunteer opinions on material that wasn't referenced in the inquiry.
Second, I think the answer as currently written addresses any
unmentioned concerns rather clearly. The regulation does not require
certification, period. In our judgement, any entity which wants to
require "certification" or specific third party testing needs to
negotiate it in their trading partner agreements. This way its up to
between the parties directly involved to identify and define costs and
testing conditions.
My two cents.
Marsha
Verizon Information Technologies
Managed Care Division
Phoenix, AZ
Home of the Back To Back NL West Champion ARIZONA DIAMONDBACKS Phone -
602.678.6042
Fax - 602.678.6331
E-mail - [EMAIL PROTECTED]
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"Falbowski,
Ellen" To: "WEDI SNIP
Testing Subworkgroup List" <[EMAIL PROTECTED]>
<[EMAIL PROTECTED] cc:
a.com> Subject: RE: Meeting
Minutes - 5/22/2003 -- comments
05/28/2003 03:38
PM
Please respond to
"Falbowski,
Ellen"
I have a couple of comments on these minutes.
1) Regarding the response to the testing issue submitted to the issues
database, I think that if Party A requires Party B to use a particular
third party's software for validation, Party A should pick up Party B's
costs, if any, of using that third party's software. However, if Party
A allows Party B to choose the validation software, Party A would not
need to pay for the validation costs.
2) X12N/TG2/SPWG2 (the work group that created the 824 Implementation
Guide Reporting IG) was notified at the February X12 meeting that
X12N/TG3 would be drafting a Type 1 Technical Report on which responses
to use when. Not sure of the status of that work.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Sent: Wednesday, May 28, 2003 3:14 PM
To: WEDI SNIP Testing Subworkgroup List
Subject: Meeting Minutes - 5/22/2003
Attendees:
Brandi Wyatt - EDIFECS
Ed Hafner - Foresight
Miriam Paramore - PCI
Kerry - EPIC Systems
Lou Oliver - Advent Software
Patrick Edwards - Arkansas Blue Cross
Tim Collins - Kentucky Medicaid
Dave Frankel - EDIFEG
Suzan Ryder - Empire Blue Cross Blue Shield
John Lilleston - Verizon
Agenda Items:
1) Review of Washington D.C. Conference:
Ed Hafner reported that the Testing breakout session went very
well. There were over 100 people in the room for the session and over 40
surveys were completed and returned to Ed after the session. Brandi
also said she overheard several positive comments about the session
after it was over. Many people liked that we were presenting actual
testing experiences and statistics but some felt that there was not
enough time provided in the session to allow the attendees to digest the
information and ask questions.
2) Issue from Issues Database:
The following issue was assigned to the Testing SWG and was
discussed during the meeting -
Can a health plan require that an entity
certify with a third party testing service
in order for the entity to begin testing
with a plan. If so, can the health plan
require that certification be obtained from
a particular third party and if so, any
caveats to that? Along these same lines, can
a health plan require that an entity certify
against its companion guidelines, with a
third party testing service in order for the
entity to begin testing with a plan. If so,
can the health plan require that
certification be obtained from a particular
third party? Any caveats to these two items?
This issue created a lot of discussion. The HIPAA legislation or
ASCA does not mention certification or verification so the issue is
pretty much left up to the formation of a best practice. The group
agreed that requiring a third party validation/certification would need
to be detailed in a Trading Partner Agreement (TPA). If a health plan
does require this type of activity, they do have the right to require a
particular third party for this purpose because certain business level
editing would also probably be built into the software used by the third
party that was specific to that particular payer. Not all third party
vendors would have that specific editing functionality because they had
not been working hand in hand with that specific health plan. The
bottom line is that validation and/or certification is not required by
the HIPAA legislation although it is recommended by the WEDI Testing
white papers. Any requirement that is outside of the scope of the HIPAA
legislation would need to be documented and agreed upon in a Trading
Partner agreement.
Please review the verbiage above as we would like to draft a final
response to this issue during the next meeting and enter it on the SNIP
website.
4) Next Steps for Testing SWG:
Sue and John had discussed a couple of topics that the Testing SWG
may want to undertake as our next steps. One idea was to develop a
white
paper as to business scenarios when the 997, TA1, 824, etc. transactions
would be used. Also, document the advantages and disadvantages of using
standard transactions versus proprietary ones until the standards are
mandated.
Brandi Wyatt also came up with another testing idea and will document
that idea to the group prior to the next meeting. We will devote an
agenda item to this subject for the next meeting and try to make some
decisions as a group.
Thanks!!
____________________________________________
John D. Lilleston
Section Manager - Healthcare EDI
Verizon Information Technologies, Inc.
Phone - (813)979-3225
Fax - (813)978-5570
[EMAIL PROTECTED]
www.VerizonIT.com
____________________________________________
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