All,
Just a reminder that we have a Testing SWG conference call scheduled for
Thursday, June 19th at 11:30 a.m eastern time. The call in number is
703-736-7290 pc 1315339. The agenda will be as follows:
1) Roll Call
2) New Testing SWG Co-Chair - Process for Nominations and Approvals
3) Issues Data Base New Issue Assigned to Testing SWG
The issue assigned to the group is:
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?
The draft response we came up with at last meeting:
Neither the HIPAA legislation nor ASCA mention certification or
verification as a requirement. As a result, the issue is basically left to
the formation of a best practice across the industry. If a payer chooses
to require a third party validation/certification, the service to be used
and the cost for that service would need to be negotiated and documented in
a Trading Partner Agreement(TPA). If a health plan chooses to 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 most
likely be built into the software used by the third party that was specific
to that particular payer. For example, not all third party testing 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.
We need to come to group concensus on this response and post to the web.
You have all seen the discussions on this issue going on via the listserv.
We need to address these issues and document a more detailed response.
Marcallee Jackson should be on the call to address her concerns and the
intent of her initial posting of the issue.
4) Testing Survey Status - Provide status to group on Steering Committee
status of approval.
5) Next Steps for Testing SWG - Update from Brandi Wyatt concerning
modified white paper outline.
Thanks and I will talk to ya on Thursday.
____________________________________________
John D. Lilleston
Section Manager - Healthcare EDI
Verizon Information Technologies, Inc.
Phone - (813)979-3225
Fax - (813)978-5570
[EMAIL PROTECTED]
www.VerizonIT.com
____________________________________________
---
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
