Provider Notice issued 06/10/04

HIPAA Transactions Available via the Internet

Last year, the Illinois Department of Public Aid (IDPA) made the Medical Electronic Data Interchange (MEDI) System available to providers and their authorized representatives. Recipient eligibility inquiries were the first transactions allowed through this system via the Internet. Electronic claim submission through the MEDI System will be available in the near future. This functionality is called Internet Electronic Claims (IEC). IEC provides a secure mechanism for providers and their authorized representative to exchange HIPAA-compliant X-12 transactions with IDPA. IEC will initially support the submission and retrieval of a limited number of X-12 transactions.

IDPA is currently piloting a revised MEDI System including the IEC, with a select group of authorized users. The conversion to the revised MEDI System, including the addition of the IEC for a limited number of X-12 transactions, is planned during July, 2004. Additional transactions will be implemented with transaction-level authorization for providers. Transaction-level authorization means that providers will designate the transactions that their representatives are allowed to use. The myIDPA Internet site will provide updated implementation schedule information as it becomes available. Go to <http://www.myhfs.illinois.gov> or click on the MEDI link from the IDPA home page at <http://www.illinois.gov/hfs/Pages/default.aspx/>.

Changes to the MEDI System

IDPA's business partners familiar with the initial recipient eligibility inquiry phase of the MEDI System will notice several changes in this new release:  

• There are now four different types of registration - Three business registration categories (provider, payee and other) and employee registration. Users that register in one of the business categories become the administrator for the "business."

• Users can register more than once. This will be helpful for users that represent provider groups or work for multiple providers.

• All registered providers will automatically have access to the IEC System. The functions available are dependent on the provider’s type. Authorization to other Internet-based systems will be added to the MEDI site in the future.

• Recipient Eligibility inquiry is now part of the IEC System. All provider types can check eligibility.

• Provider business authorization - Both payee and other business types can request authorization from a provider, and provider administrators can now authorize the “business” rather than individuals.

• Delegation of authorization – A business’ administrator is allowed to delegate authorization to their registered employees. This applies to all business types.

• Authorized users can transmit and receive one or more HIPPA compliant transaction types through the IEC System.

System Warnings

The MEDI and IEC Systems have been developed to allow providers and/or authorizing agents, submitting agents and payees to conduct HIPAA-compliant transactions with IDPA. It is important that IDPA’s providers understand and accept the responsibilities associated with the delegation of authorization of their business functions. Should a provider choose to authorize an agent as their MEDI administrator, that MEDI administrator will have full access to any MEDI transaction that you as a provider would have access to. Each MEDI administrator will need to have his or her own state of Illinois Digital Identification (digital certificate), which can be requested thru the myIDPA Web site at <http://www.myhfs.illinois.gov> . Never give your driver's license number to anyone to obtain a digital certificate under your name. It is equally important that you not share your digital certificate user ID and password with anyone else. Again, if you choose to authorize an agent as your MEDI administrator, they need to access your MEDI account under their own digital certificate identity.

If you choose to authorize a third party relationship with IDPA on your behalf, e.g., submitting agent or payee, that business entity will need to register their business in MEDI using their own digital certificate. Under MEDI, the business entity would request your authorization to specific IEC transactions. You or your MEDI administrator would grant/deny that authorization thru MEDI.

Training Viewlets

In order to assist current MEDI System users, as well as new users, to become familiar with the revised MEDI System, IDPA has developed training viewlets. The viewlets are training aids that provide a demonstration of the revised MEDI System functions. Nine viewlets are currently available, including Introducing MEDI and a viewlet for Using the IEC Application. In addition, separate viewlets for Provider Registration, Provider Account Management, Other Business Registration, Other Business Management, Employee Registration and Account Management, Payee Registration, and Payee Account Management are available. The individual viewlets allow for the training to be tailored to your type of business. A viewlet for Transaction-Level Authorization will be provided at a later date. To access the viewlets, go to < http://www.myhfs.illinois.gov> and select the MEDI/IEC Training Guides located under System News.

These viewlets are audio-visual presentations. If you have technical issues with running these viewlets from the Internet site, then contact us to request a copy of the MEDI viewlets on compact disk (CD). Also contact us if you have staff that will require training because of special needs, and they are unable to use the viewlets. To request a CD or to report special needs training, go to < http://www.myhfs.illinois.gov>, select the MEDI/IEC Training Guides link and refer to the Note Section.

Anne Marie Murphy, Ph.D.
Administrator
Division of Medical Program