Hi All, I would like to weigh in on this issue especially since it involves EDI. Medicare is regulated by the legislative enactments of the US Government and anyone practicing or supporting Medicine in the US is thereby bound. The 1996 version of HIPAA was put together to avoid competition from Europeans and a group of existing Health and Medical Record Systems. Regardless, the development and enhancement of these record systems has proceeded unabated since 1996 while HIPA has been modified to make sure my next prescription has appropriate marketing literature in it so that next time I will choose the 'right' drug. HIPAA does not fit many, many applications but what does. Performance and efficiency should have an impact. Cost does! The last poll I saw showed that roughly 20% of Medical practitioners in the US were currently using HIPAA. Hmmm! Sounds like we need a legitimate alternative. As a developer I am constantly amazed at the inability to account for the massive amounts of data generated daily in the Healthcare field. I single CT (Computed Tomography) machine can throw-away massive amounts of data presently a smaller portion as results. EDI has been available for many years. It is not rocket science. There are many people available that who eat this application and then go to lunch. The problem with the Medical/Healthcare fields is two-fold: 1)legacy, non-compatible systems, 2)multiple vendors. Possible, short-term solution: Coordinated, funded Open-Source Projects. Please include legal participation! Think about Ross Perot's methods of operation. The world is full of heterogeneous software applications that perform the same or similar functions. 'Interfaces' to the applications should be considered. This takes us back to EDI systems, e.g., interfacing to multiple heterogeneus machines in real time (a hospital operating room). We are currently building a Healthcare-related EU FP7 Grant Proposal. EDI is a big part of this. Billing is a big part of this. This is an Engineering problem (alerts, events, messaging, reporting, transactions). Comments, suggestions,etc? Please contact me at: cctualatin@speakeasy.net Regards! -Thomas Clark John M Miller wrote:
Begin forwarded message:From: John M Miller <jmmiller@msms.org> Date: January 8, 2007 4:49:09 PM GMT-05:00 To: goldenmouse@columbus.rr.com Subject: Re: EDI and Medicaid On Jan 8, 2007, at 1:19 PM, goldenmouse@columbus.rr.com wrote:Now, I'm helping a local medical practice set up its own Medicaid billing. The process, near as I can tell, runs like this: Submit Medicaid claims via EDI (format comparable to XML) to their servers, then receive, each week, a receipt for those claims as well as a direct deposit. What I'm looking for is software that manages this, preferably licensed under the GPL.Dear Goldenmouse,I am afraid you are tackling a pretty big problem. The waning days of the Clinton administration presented the business of medicine with a rather large gift in the form of HIPAA. Unfortunately The CPT codes are nothing like XML and completelyincompatible with the GPL.Remember that Ross Perot's second company is currently talking about providing free software (free as in "beer" and not as in "speech") for practice management in order to get a bigger market share of the service bureau pie. Ross Perot builthis first company processing Medicare claims.Also remember the CPT codes are owned by the AMA. The AMA may be second only to the trial lawyers in lobbying. The revenue from CPT licensing fees, in recent years,has been larger than the amount collected from member dues.I have been thinking about gathering together 20 or 30 old friends and making a set of procedure codes from scratch, all contributed from actual practitioners. XML would be a fine vehicle. I have been procrastinating for almost 6 years now.Perhaps your question will turn up more people with an interest. Regards, John M. Miller M.D.--To UNSUBSCRIBE, email to debian-med-REQUEST@lists.debian.orgwith a subject of "unsubscribe". Trouble? Contact listmaster@lists.debian.org