WEDI SNIP ID and Routing SIG


This project will publish implementation guidelines for interim and long-term identifier use and specifications for EDI Addresses. We will coordinate our findings with the 2002 WEDi / AFEHCT Health Care Communications Interoperability Work Group, which is addressing questions of infrastructure (such as directories), communications security, and communications packaging.

A Glimmer of Hope for Standards. The Workgroup for Electronic Data Interchange (WEDI) and the Association for Electronic Health Care Transactions (AFEHCT) have a joint project to develop profiles of draft standards that could become the recommended solutions for HIPAA. This project has some participation by middleware vendors, so that the solutions that are recommended would be likely to be widely available. Such a standard would greatly reduce the time required to establish and test trading partner relationships.

Implementing HIPAA Transactions Over the Internet, Wes Rishel, 23 January 2002, Gartner Note Number: T-15-3031.

We're developing recommendations for the auto-discovery of trading partners (payers, providers, third-party administrators, etc.) and their technical capabilities. Borrowing from ebXML, we plan to devise an XML schema for an electronic Healthcare Collaboration-Protocol Profile (CPP). CPPs will be located by Trading Partner ID of any participant involved in HIPAA Health Care EDI - either through a DNS-based directory of our own design, or possibly UDDI or the OASIS ebXML Registry.

This project will publish implementation guidelines for (1) the CPP to mechanically configure communication and translation software, and (2) automatic "discovery" mechanisms for locating trading partners' CPPs on the Internet based on their business identifiers.

These recommendations and specifications may someday make it easier for your automated software - or your clearinghouse - to discover that payer X is reached via a particular Clearinghouse B, or at a particular FTP or SMTP e-mail address. One scenario is how the provider will use the future National Plan ID on the patient's insurance card to "discover" the EDI address of the payer to whom claims and eligibility requests should be sent. The insurance card will contain the card issuer number which includes the (National) plan ID; using our recommendations, this Plan ID would be the (preferred) key to searching for the EDI address(es) of the ultimate payer.

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