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Executive Corner | 2019 WEDI Prior Authorization Survey
WEDI Releases Issue Brief on Common Acknowledgement Misunderstandings | Upcoming Webinars | Webinar Recap
Workgroup Roundup | WEDI Welcomes New Member | Media Spotlight
Featured Video on Demand | Latest Member News | HLTH Discount Code
Dear WEDI members,

As July comes to an end, I’m reflecting on what a busy – yet exciting – year we’ve had thus far. There seems to never be a lack of perspective or information for us to share when it comes to using health IT to improve health care information exchange – which you’ll get a glimpse of in this newsletter. Our Workgroups remain on the frontline, assisting organizations to adapt to the rapidly evolving regulatory environments by providing timely white papers, issue briefs, comment letters, webinars and surveys. We encourage you all to review and take part in our surveys, recommendations and webinars. As always, your input, participation and support to both our mission and the health care industry is invaluable.

We are now just days away from Summer Forum, and I am looking forward to connecting with all of you in Chicago. These in person events are vital, as it offers an opportunity for us all to come together in a collaborative way from various roles within health care in addressing and combating issues impacting health IT. This will be another successful and educational WEDI event for the books!

Should you ever have any questions or are interested in how you can become more involved with WEDI, please don’t hesitate to contact us.

Charles Stellar
 WEDI President & CEO
As part of WEDI’s efforts to improve health care information exchange, the WEDI Prior Authorization (PA) Subworkgroup is analyzing the current medical services PA process and developing guiding principles to support increased automation and standardization. This survey, open through August 6 th , seeks to identify barriers to adoption of standard electronic transactions for PA and possible solutions, as well as solicits feedback on the direction of the Subworkgroup’s draft Prior Authorization Workflow Barriers and Guiding Principles white paper.

To ensure that WEDI receives the best information possible from this survey, we request that  only one response be submitted per organization  based on the responder’s experience over the past year. To facilitate coordination in preparing your organization’s survey response, you can review the survey questions by clicking Review the Survey link or if you are ready to take the survey, click the Take the Survey link via the online survey tool.

Thank you in advance for your participation in this important industry initiative! 
Earlier this month, WEDI announced the development of an industry issue brief to provide guidance and information on some basic misunderstandings related to acknowledgements within HIPAA transaction exchange using the ASC X12 Version 005010 (5010). In a recent industry Acknowledgement survey WEDI issued, the need for such an educational resource was identified. The 8-page document is a high-level explanation of the acknowledgement transactions, in which it addresses the following topics:

  • What is the Acknowledgment Reference Model (ARM)?
  • What acknowledgments are currently mandated?
  • What is the purpose of the TA1, Interchange Acknowledgment?
  • What is the proper use of the 999, Implementation Acknowledgment?
  • Why is the 999 not required for the 835?
  • Why the 999 instead of 997?
  • What is the proper use of the 277CA, Claim Acknowledgment?
  • What is the difference between the unsolicited (u277) and the claims acknowledgment (277CA)?
  • If an acknowledgment reason cannot be codified, how do you request new claim status code?
  • If an acknowledgment claim category status code cannot be identified, how do you request a new category code?

Download the full Acknowledgements Issue Brief here .

For more information on WEDI’s industry efforts surrounding Acknowledgements, please visit the WEDI Acknowledgements Subworkgroup page.
Claims 101
Monday, September 9, 2019 (1:00-2:00 p.m. ET)
 
The claim is the key element in our health care system for provider payment and reporting of services performed. An understanding of the electronic claims process, what data is involved, and how the data is sent from a provider’s office to a health plan is critical for providers, vendors, and other players in the EDI fields. We will provide the basics of the claim and its submission, as well as key issues facing the industry.

WEDI is hosting this webinar   FREE for members , and non-members are also welcome to attend for a cost of $199.
Did you miss this highly attended CMS, WEDI and CAQH CORE Webinar Series? Due to popular demand, we will be hosting similar webinars in the future – stay tuned! In the meantime, you can catch up on our latest webinars in the recordings below!

All of our workgroups have special projects and activities underway, here’s just a brief highlight of a few:

  • The Acknowledgements Subworkgroup recently published an industry issue brief to provide guidance and information on some basic misunderstandings related to acknowledgements within HIPAA transaction exchange using the ASC X12 Version 005010 (5010). 
  • The Privacy & Security Workgroup is currently focusing on the WEDI educational forums – the Summer and Fall Forums, as well as planning for December in-person and web events. 
  • The Remittance Advice and Payments Subworkgroup is continuing to work on updates to the PLB Guidance paper, outlining the process and best practices for OverPayment Recovery and Forward Balances. Please join us to share your insights into this challenging process!
WEDI has an incredible group of member organizations that recognize the value our organization brings to them professionally, as a company and as an industry advocate. Here is one of our newest members. Please join us in welcoming them!
Find out more about the value of WEDI Membership.
A recent survey finds that privacy and security concerns continue to hamper the increasing interoperability of healthcare systems.

The research, based on a survey from the Trusted Network Accreditation Program (TNAP), found that survey respondents overwhelming indicate that improving the electronic movement of health information will improve patient care, notes Lee Barrett, CEO at the Electronic Health Network Accreditation Commission (EHNAC), which accredits organizations for meeting best practices for electronic data exchange.

To read the full article, visit  Health Data Management.
For nearly 30 years, WEDI has supported electronic data interchange and facilitated administrative simplification in healthcare. Lee Barrett, Executive Director of EHNAC describes what makes its promise and relevance just as important today.
Visit the WEDI Vimeo Channel to view our entire video library!
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If you are a WEDI Corporate Member organization and would like to have your press releases included in a future edition of the WEDI Monthly Newsletter, please email with a link to your press release to jennifer@andersoni.com .
The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency and to reduce costs of the American healthcare system. Formed in 1991 by the Secretary of Health and Human Services (HHS), WEDI was named in the 1996 HIPAA legislation as an advisor to HHS and continues to fulfill that role today.
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