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Re: HIPPA - 834 ENROLLMENT TRANSACTION
David, don't be putting words in my mouth, you hear?
Mike Rudolph is under the impression he MUST do the 834. HIPAA doesn't
compel his company to do any such thing. Maybe his Third Party
Administrator requires employers to enroll with the standard 834 - but
surely they would have told him of such a requirement by now, and Mike
wouldn't need to ask EDI-L about it!
If his company now manually enrolls thousands of employees annually in
its health plan, then there are probably good (technical) reasons for
him to investigate using the 834 - especially since he is assured that
the TPA must support it. A TPA is a company - often an insurance company
in its own right - that manages employers' self-insured health plans.
All health plans are required to support the 834. Therefore, supporting
the 834 would be a reasonable thing for health plans to delegate to the
TPA.
William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320
----- Original Message -----
From: "David Frenkel" <
To: "'EDI-L Mailing List'" <
Sent: Monday, 28 April, 2003 05:35 PM
Subject: RE: [EDI-L] HIPPA - 834 ENROLLMENT TRANSACTION
William,
Are you saying we shouldn't promote the use of EDI just because it is
not legally required? I just wonder if this health plan and others are
using some carrot to get employers to use the HIPAA 834.
Regards,
David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
www.gefeg.com
612-237-1966
-----Original Message-----
From: William J. Kammerer [mailto:
Sent: Monday, April 28, 2003 3:42 PM
To: EDI-L Mailing List
Subject: Re: [EDI-L] HIPPA - 834 ENROLLMENT TRANSACTION
Only employers generally enroll their employees in a health plan. And
the HIPAA TCS rule doesn't require any employer - even if it is a HIPAA
covered entity in other roles - to use the HIPAA standard 834. A plan
might, as a business consideration, require employers to enroll using
the 834, though - but HIPAA doesn't mandate it. Mike should simply ask
the Third Party Administrator who administers his company's health plan
what he should do. His company's HR department can probably continue
enrolling employees the same way they've been doing all along. There's
no reason to go rushing off looking at 834 implementation guides or
looking for work to do.
William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320
----- Original Message -----
From: "Lou Bedor" <
To: < <
Sent: Monday, 28 April, 2003 04:01 PM
Subject: Re: [EDI-L] HIPPA - 834 ENROLLMENT TRANSACTION
Added note upon re-reading. You don't, in HIPAA terms, enroll - use an
834 transaction with a provider. You enroll with a health plan. Health
plans are required to accept compliant 834 enrollments from any of their
clients - employers to payer. It gets complicated if your company is
also the plan - that is self-insured for health benefits.
LouB
Lou Bedor wrote:
----- Original Message -----
From: "Lou Bedor" <
To: <
Cc: <
Sent: Monday, 28 April, 2003 03:26 PM
Subject: Re: [EDI-L] HIPPA - 834 ENROLLMENT TRANSACTION
Yes and no. If you are a covered enitity then yes; if you are not, then
no.
According to HIPAA, a covered entity is
1) a health care provider that conducts certain transactions in
electronic form
2) a health care clearinghouse or
3 ) a health plan
For a good reference go to the following URL - it is very useful
http://cms.hhs.gov/hipaa/hipaa2/
There are also several groups concerning HIPAA. One you can join is
http://www.hipaalive.com
LouB
----- Original Message -----
From: "Mike Rudolph" <
To: <
Sent: Monday, 28 April, 2003 03:11 PM
Subject: [EDI-L] HIPPA - 834 ENROLLMENT TRANSACTION
I have seen some inquiries on the list regarding the 834 for HIPPA. Is
it true that a company offering health care plans for its employees must
send the 834/Enrollment transaction to providers by October 2003? If so,
where can I find more information about this topic and where are
downloadable implementation specs located?
Thanks,
Mike Rudolph - EDI Coordinator
Green Bay Packaging Inc.
Phone: 920.433.5426
Fax: 920.438.5426
Email:
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