Ruth, I'm not appreciating your reason for concern. This very scenario happens every day. A definition of CH in the scenario might help. These CH/aggregators I allude to are acting as clearing houses as they are taking non-standard transactions as well as providing print and mailing services. i.e., they might be a software vendor that takes proprietary, non-standard claims from their clients, translates the standard ones that are able to be submitted electronically, and submits to a bigger clearinghouse like Unisys/Envoy-then onto the payer-if they don't have a direct submitter relationship. The ones that don't or have to be sent back to the provider for additional documentation are printed out. Not a traditional CH, but a CH by definition, nonetheless.
The print mailing operation of this CH then submits the paper claims to the payer direct on behalf of the provider. I personally know a state agency that is a Unisys client for electronic transactions only, the ones that can't be submitted to a payer electronically because either the payer doesn't accept them or they need additional documentation; go to paper at the aggregator-CH level. All perfectly legal, all happens everyday, can and will continue to happen. Now, eventually, hopefully that level of paper will drop especially when and if an attachment standard is agreed upon and implemented, but not anytime soon. I for one am not a convert to the religion that this will all disappear come October, 2003. Personally, this arrangement I describe to you, I predict will be increasingly common, not decreasing so because of the high touch, high services companies like this provide to the clients especially in regards to HIPAA. They don't want to deal with a CH as you say, but they'll pay additional for a PM/Service Company to do it. They just want their claims paid. No more, and certainly no less. They can and will continue to pay small transaction fees to the PM/aggregator because it saves them time and money by managing the process. They are free to see patients and generate income. --- 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-transactions 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
