Claredi Launches HIPAA Transactions Convergence Project.

SALT LAKE CITY -- Claredi, the nation's leading provider of healthcare EDI interoperability management tools, announced that it has initiated the HIPAA Transactions Convergence Project to provide a means for the industry to converge on a common set of HIPAA Transaction Requirements. Participating in the initiative are several leading industry standards development organizations and other groups including the National Uniform Billing Committee (NUBC), the National Uniform Claims Committee (NUCC), the American Dental Association Dental Content Committee (DeCC), and the National Council for Prescription Drug Programs (NCPDP).

The goal is to help payers converge their unique HIPAA transaction data requirements, thus minimizing the need for unique data requirements in payer companion documents. This will reduce the burden for providers, who today must conform to the numerous trading-partner specific requirements found in multiple payer companion documents over and above the standards set forth in the HIPAA implementation guides.

The HIPAA Transactions Convergence Project will entail identifying the data requirements contained in payer companion documents as a simple-to-understand "requirement list" and comparing those requirements among multiple lists. The result will make it possible to determine the areas in which a particular guide differs from other guides. These comparisons can then be used by payers to see how their own requirements differ from those of their peers for equivalent transactions, or to see how their requirements differ from the recommendations of the data content committees. Being able to identify the differences and similarities among companion documents will provide the basis of information needed by payers to converge their HIPAA transactions requirements into a common set of requirements.

The data content committees will be able to use the requirements lists produced by the Convergence project to identify the data elements that are actually used and not used by the industry. Gathering this information is an important step in refining the requirements for a second generation of HIPAA transaction implementation guides that could be adopted by the Secretary as new standards in the future. The Convergence project provides a unique set of tools for this purpose.

In addition, providers, practice management vendors, and clearinghouses can use the Convergence project requirements lists to easily locate the differences in requirements among the various payer-specific companion guides -- information that will simplify the preparation of transactions for specific payers. The requirements lists can be viewed with a web browser and can also be downloaded in a couple of different electronic formats. As practice management systems incorporate these requirements into their software, the transaction data can be validated at the source against the corresponding requirement list automatically. This validation will reduce the burden of compliance with all the companion guides, lower the cost of implementation of the transactions and achieve the original HIPAA goal of administrative simplification.

Claredi will be jump-starting the Convergence project by creating requirement lists, extracting the information from the almost 1,000 companion guides that Claredi has already identified and built into its validation systems. Claredi will convert this growing number of companion guides and pharmacy payer sheets into Convergence requirements lists over the next few months. Each payer that has published a companion guide is invited, at no cost, to use the Convergence project web site to create and maintain its own requirements lists and to make the information easily downloadable by its trading partners.

Claredi provides free access to the HIPAA Transaction Requirements Lists, a visual comparison tool that presents the differences in requirements for up to ten companion guides, side by side, in an easy to understand format. Claredi will also provide free Convergence Project accounts that enable payers and others to define and maintain their own requirement lists for all their HIPAA Transactions. The Convergence project is open to the entire industry and there is no charge for participating. Details can be found on the Claredi website at http://www.claredi.com/convergence/.

About Claredi

Claredi is a Salt Lake City-based company that pioneered the concept of transaction validation under HIPAA and counts more than 1,200 major healthcare organizations -- payers, providers, clearinghouses and vendors -- among their customers. The company's classic validation methodology has been exclusively endorsed by the American Hospital Association. Today, Claredi provides comprehensive EDI validation (of which HIPAA is only a part) and interoperability management tools to enable healthcare organizations to assess compliance, document due diligence, achieve interoperability with their trading partners, and more efficiently manage the ongoing evolution of their EDI. For more information, visit www.claredi.com.