EDI Partnership for electronic data interchange (Security Health Plan)
EDI Partnership supposes that Security Health Plan is unable to accept electronic transmissions of claims or other transactions set forth in the HIPAA Transactions/Code Sets regulations other than in the standardized format required by those regulations. If the affiliated provider transmits the transactions electronically to Security Health Plan using EDI Partnership, he or she will need to transmit them in the standardized format or use a clearinghouse to do so.
Direct or service provider alternatives
Either Security Health Plan or the affiliated provider may transmit documents to each other directly or through a third party provider designated by the transmitting party (“provider”). Either Security Health Plan or the affiliated provider may designate additional providers upon written notice to the other party.
Systems operation
Security Health Plan and the affiliated provider are responsible for ensuring that it or its providers can effectively and reliably transmit and receive documents and shall be liable for the acts or omissions of its providers while transmitting, receiving, storing or handling standard transactions, or performing related activities. If Security Health Plan and the affiliated provider use the same provider to effect the transmission and receipt of a standard transaction, the originating party shall be liable for the acts or omissions of the provider as to such standard transaction.
Allocation of costs
Security Health Plan and the affiliated provider shall be responsible for the payment of its own fees and other charges incurred or assessed by it in transmitting or receiving documents, including, without limitation, those fees charged by any of its providers.
Test modification
If Security Health Plan or the affiliated provider (the “requesting party”) applies to DHHS and obtains, for testing purposes, an exception from the use of a standard transaction, the requesting party shall provide the other party 30 days’ prior written notice of such exception. Effective at the end of such 30-day period, the other shall modify its transmission and/or receipt of documents to comply with the granted DHHS exception. If this occurs, trading partner agrees that it will participate in such test modifications.