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RE: HIPAA Article
Michael,
Your first point is a good one, but understanding why the transactions
are difficult doesn't make them any easier to implement.
Point two, I don't think anyone is asking you to have sympathy, except
as we all use this forum to commiserate, as the people on this list are
not the ones (generally) making the decisions or spending the money,
we're the ones begging, lining up arguments, providing well reasoned
explanations and being ignored until the "deadline" is only months or
weeks away. As an adjunct, it is a government deadline and, as such,
has been delayed numerous times and may be even more.
Your last point is really off point, Doctors have ABSOLUTELY nothing to
do with healthcare EDI except submitting claims, which brings me to my
last point:
Insurance companies (who are involved, albeit reluctantly) make a
tremendous amount of money off the "float", so delaying payment is GOOD
fiscal sense for them, and they like using the paper excuse.
Implementing ways to streamline and process more quickly cost them in so
many ways they will continue to drag their feet as long as they can.
It's only logical and economically prudent. Why do you think this is a
GOVERNMENT driven implementation? All other industries who use EDI
found the benefit and the impetus from within, there is little or no
cost benefit in EDI to the money makers in the health care industry.
I wish good luck and aspirin to all those who put so much effort into
claims EDI, I gave up after 6 months of pounding my head against that
particular wall.
Leah
-----Original Message-----
From: Michael Mattias [mailto:
Sent: Sunday, April 14, 2002 6:59 PM
To: EDI-L Yahoogroups
Subject: Re: [EDI-L] HIPAA Article
> There had been some discussion a few years back that HIPAA would
> encourage more medical supply chain e-commerce/EDI but it looks like
> getting HIPAA/EDI going has become more challenging that expected as
> Rachel eluded to.
You know, this whole thread -dealing with "how difficult the EDI
healthcare
transaction sets are to implement" and their relative difficulty versus
the
sets used in the manufacturing/distribution industry - has hit a sore
spot with
me.
First, the only reason the health care transaction sets are so difficult
is
because the underlying application is more complex. There's a lot more
involved in a health care claim than quantity, part number and unit
price, so
why should anyone be surprised that the 837 is more difficult to
implement than
the 810 or 811? (Duh!). (Frankly, I think the code-set standardization
is a
far greater technical challenge than the ANSI ASC X12 format).
Second, I have no - that's zero, none, nada, zip, squat - sympathy for
anyone
who was not prepared to use "HIPAA-standard" transaction sets as
originally
scheduled. The HIPAA was passed in 1996; everyone in the industry should
have
been watching for the regulations, and anyone who WAS watching certainly
should
have been clued in that the standard transactions were going to be
defined as
ANSI ASC X12 EDI. The actual regulations and specifications for the
claim came
out in August, 2000 with more than TWO WHOLE YEARS to implement by the
original
date of October, 2002.
Tell me truthfully: do you really want someone who couldn't get ready in
more
than six years standing over you with a scalpel?
Michael Mattias
Tal Systems, Inc.
Racine WI
Michael Mattias
Tal Systems, Inc.
Racine WI
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