Payers should test or retest:
q
When
a trading partner implements a new system, system upgrade or EDI translator
that affects the production of any exchanged electronic transaction
q
As
transaction file formats change or new EDI transactions become required by
HIPAA
q
As
clearinghouses add new providers
q
When
changing intermediaries or clearinghouses
q
If
it is determined that a trading partner is submitting transactions that are not
HIPAA compliant
q
When
a trading partner implements new lines of business which may have unique
requirements for specific service areas (e.g. chiropractic, ambulance, and home
care)
Providers should test or retest:
q
When
a trading partner implements a new system (i.e. claims processing system),
system upgrade or EDI translator that affects the production of any exchanged
electronic transactions
q
As
transaction file formats change or new EDI transactions become required by
HIPAA
q
If
it is determined that a trading partner is submitting transactions that are not
HIPAA compliant
q
When
changing intermediaries or clearinghouses
q
When
implementing new lines of business which may have unique requirements for
specific service areas (e.g. chiropractic, ambulance, and home care)