I'm not a payer, but I'll butt in anyway:

1) - not doing any "compliance" checking at all - is almost impossible!
Even if no validation beyond the X12 syntax level is done in the
translator, surely the back-end system is doing some kind of editing and
consistency checking! For example, maybe the translator is set up to
just move diagnosis codes from the EDI HI segment into consecutive
database or flat file fields. Surely the back-end would check the
validity of the codes, ensure there are no duplicates and figure out
whether they make sense in the context of the claim or the plan.
Likewise for dates: it's possible the translator has no - or
rudimentary - capability for editing for the syntax of DTP dates.
Instead, the backend would check to make sure the dates are
syntactically valid (e.g., CCYYMMDD) and they make sense in the context
of the claim, subscriber or patient (i.e., the claim is not submitted
before the date of service).

2) - Doing Compliance checks only during the development and testing
stage. If this means using a third-party testing tool to validate EDI
data in order to ensure that your maps and back-end logic are working, I
would most emphatically agree. Even the pros like Doug Webb probably
can't "eyeball" EDI data to make sure it's perfect! - a desktop or
web-based checking tool is to EDI mapping like a debugger is to C++
programming! Note that even though "checking" is a by-product of an
online certification service, it will be useful to have a desktop
checker for programmer convenience.

3) - Do compliance on all incoming files, send out a 997, but don't
reject anything. The translator will automatically generate positive or
negative 997s depending on the absence or severity of X12 syntax errors.
If there are X12 syntax errors, at a minimum the entire transaction set
must be rejected, as translation will probably be rendered impossible
(e.g., the translator would lose its way if a mandatory segment is
missing). The 997 can't report on HIPAA compliance violations - e.g.,
there's no way for the 997 to say a diagnosis code is invalid or out of
date. You must use an 824 or other application acknowledgment
transactions for reporting most HIPAA "compliance" errors - or e-mail or
fax.

4) - Reject the ST/SE pair that contained the compliance error and
accept the rest of the file. You can do this, but it is somewhat
drastic: do you really want to reject an entire 837 with thousands of
claims in it, even though only one had an invalid diagnosis code? Again,
a 997 can't be used for any but X12 syntax errors. The 824 or other
application acknowledgment transactions give you finer-grained control
over which pieces-parts you can report on as having been rejected.

5) - Reject the entire file - is a variant of 4). I would offer the same
advice: use the 824 or other application acknowledgment transactions
(see the WEDI/SNIP Business Issues Front-End Edits white paper) to
reject only the pieces-parts with serious compliance errors in the data
you actually map and use.

6) - Other. What "Other" is there?

Note that commercial compliance checkers can't or shouldn't do anything
with transactions that fail compliance - other than to issue errors and
warnings in a report or a file that can be used to generate a subsequent
824. Generally, only your back-end can "reject" for HIPAA compliance
errors (though the translator can handle X12 syntax errors with the
997).

Some translators promise to do "compliance" editing, but I'd generally
be loathe to trust it being done during translation. It's duplicative of
what you're going to be doing in your front-end edits and back-end
systems where you should be on the lookout for making sure stuff makes
sense in the context of HIPAA. Your translator should stick to the
knitting and simply translate. See my comments Re: Translator Validation
Level from 29 Jan 2003 at
http://www.mail-archive.com/[EMAIL PROTECTED]/msg01212.

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

----- Original Message -----
From: "Schmidt, Michael" <[EMAIL PROTECTED]>
To: "WEDI SNIP Transactions Workgroup List"
<[EMAIL PROTECTED]>
Sent: Monday, 31 March, 2003 05:34 PM
Subject: HIPAA Compliance checks and compliance failures


As I payor I'm interested in finding out how other entities are going to
be handling transactions that are not HIPAA Compliant.  There are
commercial compliance checkers available out there, the question is what
you do with the transaction that fail compliance.  It seems to fall into
several broad categories:

1)  Don't do Compliance checks at all--if I can process the transaction
through my back-end system I'm happy.
2)  Do Compliance checks only during the development and testing stage
with a given trading partner.
3)  Do compliance on all incoming file, send out a 997, but don't reject
anything.
4)  Reject the ST/SE pair that contained the compliance error and accept
the rest of the file.
5)  Reject the entire file.
6)  Other

Where does your organization, and others you've worked with, fall on the
above list?

Thanks


Mike Schmidt
Ochsner Health Plan
504.219.8189
[EMAIL PROTECTED]



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