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Paper: EDI Network Ready for Clinical


September 2, 2008

A white paper from a committee of the Healthcare Information and Management Systems Society calls for the existing claims clearinghouse network for HIPAA financial/administrative transactions to be expanded and become the national network for clinical transactions.

The clearinghouse industry has been building its network for 25 years and its vendors are covered entities under the HIPAA transactions, privacy and security rules, according to authors of the paper. Further, many clearinghouses are accredited by the Electronic Healthcare Network Accreditation Commission for meeting specific criteria for performance quality and integrity.

“Unfortunately, many decision makers are disregarding or are not adequately informed of this existing, fully functional information highway and are investing tremendous funds, time and effort into the analysis, prototyping and development of new exchange mechanisms to support RHIOs and HIEs,” according to the report. “These regional entities are developing slowly and could benefit from strong coordination with health care clearinghouse networks.”

The HIMSS Financial Systems Steering Committee developed the white paper, “The NHIN Highway is Already Paved: The Existing HIPAA Transaction Exchange Network is an Able Solution for the Conveyance of Clinical and Administrative Information.”

Committee members who led development of the white paper include two representatives of clearinghouses and one from a revenue cycle management software vendor, two representatives of provider organizations, and a representative of the federal government.

For text of the paper, click here.

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