Chris,
HIPAA requires that "covered entities" exchange information using
standard transactions identified by the rule (X12 being one of these).
"covered entities" are health plans, health care clearinghouses, and
health care providers who transmit electronically.
Corporations were originally excluded from the rule. However, the
exception for transmissions within corporate boundaries was also
eliminated in the final rule.
Your comment "it seems to me that the legislation is meaningless" is
a little premature. As far as I can tell the only ones excluded from
the rule are the Dr. Marcus Welby's of the country.
Linda Thomas
Programmer/Analyst, Interface Team
4646 West Lake Park Blvd.
Salt Lake City, Utah 84120-8212
E-mail: [EMAIL PROTECTED]
Phone: (801) 442-4280
Fax: (801) 442-6066
>>> Chris Thompson <[EMAIL PROTECTED]> 08/31/00 02:11PM >>>
There are none that I am aware of. HIPAA says that if you
send directly from provider to payer, or vice-versa, you
cannot use XML - you must use X12. I talked with Gary
Christophe, the CIO of HCFA, and he is personally very
interested in XML. He agrees, though, that it will be *at
least* three years before it would replace X12. I can say
for certain that the industry will not be pleased if it
would come that soon.
You can send/receive XML if you use a clearinghouse, as
most payers/providers do in healthcare. As far as I know,
there is no benefit to sending an XML transaction to the
clearinghouse, or receiving one, as they will charge you
the same regardless of the transaction type. I would be
interested in hearing anything from any clearinghouses if
that isn't the case.
The surprising thing to me about the new HIPAA legislation
is that it apparently requires you to use X12 only if you
don't use a clearinghouse. As virtually everyone does use
a clearinghouse, virtually everyone doesn't have to do
anything. And since a clearinghouse is defined
circuitously as an entity that remaps data between two
partners, it seems to me that the legislation is
meaningless.
Any other reads on the legislation would be much
appreciated!
Chris Thompson
Executive Vice President
Recognition Research, Inc.
1750 Kraft Dr. Suite 2000
Blacksburg, VA 24060
540.961.6500
540.961.3568/fax
[EMAIL PROTECTED]
www.rrinc.com
B382000331
On Thursday, August 31, 2000 2:01 PM, sameer rao
[SMTP:[EMAIL PROTECTED]] wrote:
> Hello Group,
>
> Are there any organizations/Groups working on
> Schemas or DTD for EDI transactoins specific to
> HealthCare industry. With the HIPAA legistalation, all
> of the HealthCare industry should be ready to Receive
> and Respond for x12 EDI Transaction 837/835 and
> others.
>
> Is there ongoing effort to have these EDI
> transactions mapped onto XML ? Are there any Schemas
> or DTD being created ? Do reply if anyone has any
> information on these.
>
> Thanks much,
> -SvR.
>
>
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