Linda, I'd like the answer to that question, too. This may be one of
those FUD (Fear, Uncertainty and Doubt) moments. Sure, there are all
sorts of sections in the TCS rule regarding the conducting of electronic
transactions as standard, but nothing comes right out and says you're in
big trouble if you accept non-standard transactions.

But, gosh, they keep on talking about "standard," so I think they're
pretty serious that you shouldn't just be a scofflaw and keep taking in
NSF or print image UB-92 claims. But I bet you knew that already, and
just wanna know what says you're gonna go to prison if you happen to let
an imperfect HIPAA X12 transaction in, and - Lord forbid - actually pay
it. Probably nothing is going to happen, regardless of what all the
fear-mongers might say. The TCS penalty process is complaint-driven -
and who's around to complain? The provider got paid, and if he has any
legitimate gripes it won't be because you allowed extra blanks after the
provider's last name or ignored trailing sub-element delimiters!

If you're "into" citations, consider that � 162.923(a) says covered
entities have to conduct "covered" transactions as standard. And �
162.925(a)(1) says the health plan must conduct a "covered" transaction
as standard (as opposed to paper, I suppose), if requested to do so.

There's nothing explicitly saying that you need to reject inbound
transactions that are not perfectly HIPAA compliant. And who's perfect -
or needs to be - anyway? This isn't blood type matching, after all.
There is a big "negative" in there, though: you MUST always take in
*perfectly* complying transactions - 'cause if you don't, the provider
will be ticked off and will be sure to complain.

It might help if you gave us an example of what you're thinking of
letting "slide" in after H-day.

William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320

----- Original Message -----
From: "Linda Young" <[EMAIL PROTECTED]>
To: "WEDI SNIP Transactions Workgroup List"
<[EMAIL PROTECTED]>
Sent: Thursday, 13 March, 2003 12:40 PM
Subject: Non-compliant inbound transactions



I would really appreciate your help on this very basic question.

As part of HIPAA compliance I understand that we must send compliant
outbound EDI transactions. My question is, are we supposed to reject
inbound transactions that are not HIPAA compliant? Can anyone point me
to a section in the final rule or federal register (or any HIPPA
official document or IG) that states that we should reject inbound
transactions that are not HIPAA compliant?

Thanks

Linda


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