A draft version of X12N's version 005010 275 Additional Information to
Support a Health Care Services Review Implementation Guide,
005010X211, is now available for public review and comment as a key
step in its X12 Type 3 Technical Report (TR3) publication process.

The public comment period for this guide opened on 27 January 2006 and
will close on Monday, 27 March 2006, at 8:00 pm Eastern time.

The purpose of this 275 Implementation Guide is to:
· send additional information about a health care services review,
· send supportive information for the processing of a prior
authorization request,
· send additional information from provider to provider for a patient
referral or in response to a referral,
· provide a mechanism for the exchange of patient information between
health care entities, and
· provide a standardized way to convey attachment content.

This guide was developed with the assumption that standardized sharing
of patient medical information is needed:
- for the purposes of establishing medical necessity for treatment
plans,
- for conveying prior evaluation and treatment information for referrals
and follow-up care, and
- for reporting findings and recommendations to referral sources.

NOTE THAT THIS GUIDE IS SEPARATE AND DISTINCT FROM THE
version 004050 275 Additional Information to Support a Health Care Claim
or Encounter guide that just exited public comment as part of the
federal HIPAA Claims Attachments Notice of Proposed Rule Making. Both
275 guides do, however, point to Health Level Seven (HL7) Additional
Information Specifications to further specify data formats and data
content.

This is X12's only unconstrained public comment period for this
Additional Information to Support a Health Care Services Review guide.
The authors of this guide will consider all comments during and
following the public comment period. For a complete understanding of
changes being suggested and/or made to this guide, reviewers should
monitor the on-line conference during the public comment period and
consider all author responses prior to the Informational Forum.
Official authoring work group responses will be posted to the on-line
conference at least 15 days prior to the Informational Forum.

An announcement of the Informational Forum will be made later. The
Informational Forum, held during an X12 Trimester Meeting, probably the
one during the first full week of June, 2006, [see
http://x12.org/x12org/meetings/x12trimt/index.cfm ], is the final X12
opportunity to comment: but generally only on modifications based on
the received public comments. After that, the guide is finalized for
movement through the Insurance Subcommittee (X12N) and X12 publication
approval processes.

The draft implementation guide is available for free download at:
http://www.wpc-edi.com/products/publications/x211 . Comments on the
draft may be submitted by anybody -- X12 member or not -- via the
on-line conference at:
http://www.wpc-edi.com/conferences/tg2/implementationguides .

This Additional Information to Support a Health Care Services Review
Implementation Guide, 005010X211, is a brand new, first time document.
It's, obviously, not a counterpart of any that have been adopted under
HIPAA, and no official discussions regarding any such adoption have been
held. A factor in such discussions, should they be initiated, will be
any comments received. Voluntary use, once this guide is published as a
TR3, is, of course, permissible at any time based on negotiated
agreements between willing trading partners. HIPAA is a floor, not a
ceiling!

Participation in the public comment period for this guide is open to
all who may be interested; whether or not members of Accredited
Standards Committee X12. Please participate -- this is the highest
leverage opportunity for anybody outside of the authors to impact this
document.

Dave Feinberg
Co-chair, HIPAA Implementation Work Group
Insurance Subcommittee (X12N)
Accredited Standards Committee X12
Rensis Corporation [A Consulting Company]
206-617-1717
DAFeinberg@...