----- Original Message -----
Sent: Thursday, November 14, 2002 9:49
PM
Subject: RE: 275 attachment
Those of you who know me know
it was only a matter of time until I sent this:)
Lets not jump the gun on this. The intent of the
standardized 275 / HL7 attachment was never to prohibit a payer(s) with
demonstrated need to be able to create and request certain attachments.
Requests for all new attachment types will go through the same process
(DSMO, NCVHS) as do requests for any other kind of data content desired to be
included in IG's adopted for use under HIPAA. Bottom line...payers won't
randomly develop their own attachment types - remember these are standards
that are "adopted" under HIPAA, therefore they go through the same public
review processes as all others.
As
for the definition of an "attachment" I suspect this will be better worked
through once the NPRM is out and the industry comments. I know that
there is NO hard fast rule for this definition as of today. I will also
say that the intent of the developers of the attachment recommendation
was never for it to be required by a payer for every single claim they receive
from a provider. This was never even discussed and it would not be
supported by our committee. If I had to speculate I'd say it's a safe
bet that it was never the intent of CMS either.
This isn't an "easy" topic - there are a lot of layers
of issues once you start peeling the onion. We hope that having created
a standard way to transmit this information electronically will be viewed by
the healthcare community as the very positive thing that it is. Beyond
that, we have to start working through the policies, business issues etc that
will be relevant to such an electronic transmission.
The Attachment SIG in HL7 has been working on these
kinds of things since 1997. We invite any and all who feel they have
something positive to contribute to the electronic claims attachment
discussion and development to join us. The more people that get involved
and give their input now, the better off we'll all be.
Maria
Maria
Ward
PricewaterhouseCoopers, LLP
Healthcare Consulting Practice
CoChair, HL7 ASIG
Chair, DSMO Steering Committee
Member,
NUCC
312.298.2586
|
| "Carlin, Kathy (Contractor)"
<[EMAIL PROTECTED]>
11/14/2002 03:05 PM
Please respond to "WEDI SNIP Transactions Workgroup List"
|
To:
"WEDI SNIP Transactions Workgroup List"
<[EMAIL PROTECTED]>
cc:
Subject: RE: 275
attachment |
Zon, your comments are very encouraging. If payers
can require attachments for any data they want, then the standards lose their
effectiveness, and providers are back in the business of supporting separate
requirements by payer. Is anything being done to build this into the
regulations?
Thank you,
Kathy Carlin, Principal
Consultant
Siemens Medical
Solutions
UCLA Phone
310-301-5219
UCLA email: [EMAIL PROTECTED]
Siemens Voicemail
610-219-2067
Siemens email:
[EMAIL PROTECTED]
-----Original Message-----
From: Zon
Owen [mailto:[EMAIL PROTECTED]]
Sent: Thursday, November 14, 2002
10:56 AM
To: WEDI SNIP Transactions Workgroup
List
Subject: Re: 275 attachment
Suzanne,
I can't cite a regulation or an HHS FAQ on this,
but Stanley Nachimson of HHS has stated on a number of occasions something to
the effect that an attachment that is required with every claim is the
equivalent of adding data to the claim standard, and would thus be
problematic. I.e., if it is needed all of the time, it should be part of
the claim, not part of an attachment, and you can't unilaterally add data to
the claim transaction. So you might want to contact HHS directly on
this.
- Zon Owen -
(808)597-8493
----- Original Message -----
From: Suzanne Azariah
To: WEDI SNIP Transactions Workgroup List
Sent: Tuesday, November 12, 2002 8:04
AM
Subject: 275 attachment
Dear Group Members,
We would
like to know if we can require a 275 for every 837. This would give us
the ability to collect data such as DSMIV codes and and more definitive
ethnicity codes. Is there a reason why this cannot be done?
Thanks.
Suzanne
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