I wish the raw data was available (is it, somewhere?). I'd love to do some statistical analysis on this and get some real insight about how different insurance companies treat claims.
You mean you also have claim data (837)? Or do you just have enrollment data (834)?
If the former, I wonder if some statistical analysis could be done in order to detect possible fraud, waste, and abuse. (I'm not a data geek or anything, but have I always wanted to learn.)
Just curious - how is it that you have claim data? In fact, how is it that you (if I'm not misunderstanding) are storing any actual live data whatsoever?
Just to clarify...you have some data with patient identifiers already "removed"...or are you stripping it yourselves before sharing?
If the latter (which I hope is not true), how would a third-party like you obtain identifiable data? Why would a third-party providing an eligibility API end up storing data (particularly claim data) of any kind to offer to share?
Hey logjam! Let me know what specialty you are and how many insurance companies you currently accept when you have a minute. To answer your question: No, we do not have access now nor plan to have access in the future to claims data. The raw X12 I am referring to is a 271 format only (eligibility) and will be generated by our own sample transformation tool. However; it will be based off data passed (with stripped patient identifiers) through the Eligible API so that it can give shape to the differences between payer (insurance) formats. As of 3:05 8/11 I have not shared any yet, but I hope to push some to production by the end of the day!
So actual patient data is being stored and manipulated, and manually "stripped" so that it can be posted (in effect) to the web? Again, I don't want to misunderstand you, but you feel comfortable doing this? I wouldn't.
Please provide your backup, retention, deletion, access logging, etc., policies on that data you are manipulating.
Am I understanding that an audit two months from now (you log your access and use of this data as required by HIPAA, right?) will indicate that this data was "stripped" and shared?
I would be very very cautious about thinking that "stripping" data like this isn't very prone to error, and to not realizing that storing and sharing this kind of data without a lot of care and thought could create huge problems.
