Trading Partner Obligations. In addition to the requirements of Section 2.1 and 4.1, the Trading Partner shall be specifically obligated as follows:
(a) To refrain from copying, reverse engineering, disclosing, publishing, distributing or altering any Data, Data Transmissions, DMH provided interfaces, or applications, or use of the same for any purpose other than that for which the Trading Partner was specifically given access and authorization by DMH;
(b) To refrain from obtaining Data, Data Transmission(s), access to DMH interfaces or solutions for any purpose other than access DMH expressly authorizes to said Trading Partner. Furthermore, in the event that the Trading Partner receives Data, Data Transmissions, or access other than expressly authorized by DMH, Trading Partner shall immediately cease use of said Data, Data Transmission(s), interface(s) or application(s), notify DMH and make arrangements to return Data or Data Transmission. Upon confirmation of receipt by DMH of said Data, Data Transmissions, Trading Partner shall immediately destroy Data and/or Data Transmission contained in such Data Transmission from its System, records, or network(s).
(c) To implement security measures to ensure the integrity and confidentiality of both DMH and the Trading Partner’s data and/or records when the System is not in active use by the Trading Partner.
(d) To protect and maintain the confidentiality of the DMH issued Secure Identification Tokens of the Trading Partner or Agent at all times.
(e) To enforce encryption and secure authentication where appropriate, by utilizing complex passwords and/or by other mutually agreed upon means in order to ensure the transmission of the data is maintained secure during all data exchanges between Trading Partners and DMH.
(f) Prior to or upon execution of the underlying contract, provide DMH, in writing, all of the information requested in the Trading Partner Information section of the TPE online application. While the underlying contract is in effect, the Trading Partner shall notify DMH in writing no later than ten (10) business days of any material changes in the information originally provided by the Trading Partner in the TPE online application.
(g) To minimize the risk of data loss during transmissions, Trading Partners must notify DMH of any planned System changes at least 30 days prior to any change.
Trading Partner Obligations. Trading Partner shall:
(a) Not copy, reverse engineer, disclose, publish, distribute, alter or use Proprietary Information in or derived from data, Data Transmission or Envelope for any purpose other than for which BCBSSC has specifically authorized Trading Partner under the terms of this Agreement.
(b) Not obtain access by any means to data, Data Transmission, Envelope, or BCBSSC’s Operating System for any purpose other than as BCBSSC has specifically granted Trading Partner access under this Agreement. In the event that Trading Partner receives data or Data Transmissions not intended for Trading Partner, Trading Partner shall immediately notify BCBSSC and make arrangements to retransmit or otherwise return the data or Data Transmission to BCBSSC. After such retransmission or return, Trading Partner shall immediately delete the data and Data Transmission from its Operating System.
(c) Protect and maintain the confidentiality of Security Access Codes issued to Trading Partner by BCBSSC, and limit disclosure of Security Access Codes to authorized personnel on a need-to-know basis.
(d) Provide promptly to BCBSSC in writing all information requested in its standard enrollment forms. While this Agreement is in effect, Trading Partner shall notify BCBSSC in writing within one (1) business day of any material change in the information on those forms.
Trading Partner Obligations. Trading Partner will:
(a) Not copy, reverse engineer, disclose, publish, distribute, alter or use Data, Data Transmission or Envelope for any purpose other than for which DHS has specifically authorized Trading Partner under the terms of this Agreement.
(b) Not obtain access by any means to Data, Data Transmission, Envelope, or DHS’s Operating System for any purpose other than as DHS has specifically granted Trading Partner access under this Agreement. In the event that Trading Partner receives Data or Data Transmissions not intended for Trading Partner, Xxxxxxx Partner will immediately notify DHS and destroy the data.
(c) At its own expense, obtain and maintain its own Operating System necessary for timely, complete, accurate and secure transmission of data pursuant to this Agreement. Furthermore, Trading Partner shall pay its own costs for any and all charges related to Data Transmission under this Agreement and specifically including, without limitation, charges for Operating System equipment, software and services, charges for maintaining an electronic mailbox, connection time, terminals, connections, telephones, modems, internet service providers and any applicable minimum use charges. Trading Partner will also use the claims transmission method dictated by DHS. Trading Partner will maintain its mailbox by deleting or downloading messages on a timely basis.
(d) Protect and maintain the confidentiality of Security Access Codes that DHS issues to Trading Partner.
(e) Provide DHS in writing all information requested in the EDI Registration and the Electronic Funds Transfer form not later than Trading Partner’s execution of this Agreement. While this Agreement is in effect, Trading Partner will notify DHS in writing within five (5) business days of any material change in the information on to this Agreement.
(f) Require any Business Associate to abide by the obligations set forth in this Section 3.2, even though Business Associate is not a signatory to this Agreement. The requirements in this section must comply with the requirements of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (45 C.F.R. Parts 160-164).
Trading Partner Obligations. 4.1 Trading Partner will not change any definition, data condition or use of a data element or segment in an ANSI ASC X12N Transaction Standard’s implementation guide specifications.
Trading Partner Obligations. A. Pursuant to 45 C.F.R. §162.915, Provider shall not do any of the following:
i. Change the definition, data condition, or use of a date element or segment in a standard;
ii. Add any data elements or segments to the maximum defined data set;
iii. Use any code or data elements that are either marked “not used” in the standard’s implementation specification or are not in the standard’s implementation specification(s); and
iv. Change the meaning or intent of the standard’s implementation specifications(s).
Trading Partner Obligations. Trading Partner will:
(a) Not copy, reverse engineer, disclose, publish, distribute, alter or use data, data transmission or envelope for any purpose other than for which Company has specifically authorized Trading Partner under the terms of this agreement.
(b) Research and correct any and all billing discrepancies at no expense to the Company.
(c) Not obtain access by any means to data, data transmission, envelope, or Company’s operating system for any purpose other than as Company has specifically granted Trading Partner access under this agreement. In the event that Trading Partner receives data or data transmissions not intended for Trading Partner, Trading Partner will immediately notify Company and make arrangements to retransmit or otherwise return the data or data transmission to Company. After such retransmission or return, Trading Partner will immediately and permanently delete the data and data transmission from its operating system.
(d) Protect and maintain the confidentiality of security access codes (codes that Company assigns to Trading Partner to allow Trading Partner access to Company’s operating system for the purpose of executing data transmission) issued to Trading Partner by Company.
(e) Limit disclosure of security access codes to authorized personnel on a need-to-know basis, and complete the appropriate security access form (as applicable) as specified by the Company.
(f) Agree that the Company has a right to periodic updates, at its request, of current and active business associates and their associated transactions when Trading Partner submits transactions on behalf of third- parties
Trading Partner Obligations. The Trading Partner agrees to the following:
3.1 Trading Partner hereby agrees that it will not change any definition, data condition or use of a data element or segment as proscribed in the HHS Transaction Standard Regulation (45 C.F.R. § 162.915(a)).
3.2 Trading Partner hereby agrees that it will not add any data elements or segments to the maximum data set as proscribed in the HHS Transaction Standard Regulation (45 C.F.R. §162.915(b)).
3.3 Trading Partner hereby agrees that it will not use any code or data elements that are either marked “not used” in the Standard’s implementation specifications or are not in the Standard’s implementation specifications. (45 C.F.R. §162.915(c)).
3.4 Trading Partner hereby agrees that it will not change the meaning or intent of any of the Standard’s implementation specifications. (45 C.F.R. §162.915(d)).
3.5 Trading Partner hereby understands and agrees to submit Connecticut Medical Assistance Program-specific data elements in accordance with the Connecticut Medical Assistance Program Specific Billing Guides, to the extent that the Connecticut Medical Assistance Program-specific data elements do not change the meaning or intent of any of the Standard’s implementation specifications (45 C.F.R. §162.915(d)) or do not change any definition, data condition or use of a data element or segment as proscribed in the HHS Transaction Regulation (45 C.F.R. §162.915(a)).
3.6 Trading Partner who is a Provider hereby agrees to adequately test all business rules appropriate to its types and specialties. Trading Partner who is a Billing Agent or a health care clearinghouse hereby agrees to adequately test all business rules appropriate to each and every provider type and specialty for which it provides billing or health care clearinghouse services.
3.7 Trading Partner agrees to cure Transactions errors or deficiencies identified by DXC Services, and Transactions errors or deficiencies identified by a Provider if the Trading Partner is acting as a Billing Agent or a health care clearinghouse for that Provider. When Trading Partner is a Billing Agent or a health care clearinghouse, Trading Partner agrees to properly communicate deficiencies and other pertinent information regarding electronic transactions to enrolled providers to which they provide services as a Billing Agent or a health care clearinghouse.
3.8 Trading Partner agrees and understands that, from time to time, the federal Department of Health and Human Services (“HHS”) may ...
Trading Partner Obligations. (a) Trading Partner accepts and agrees to the terms and conditions for EDI transactions as stated in this Agreement, its attachments and the Parent Company EDI User Guide Manual which is incorporated by reference herein. Trading Partner agrees and understands that there exists the possibility new HIPAA transactions may be adopted in the future and thus agrees to test all new transaction sets.
(b) Trading Partner will submit transactions only on behalf of those individuals who have given their written authorization to do so. Upon request from PARENT COMPANY, Trading Partner shall furnish to Parent Company certification, including when requested by Parent Company, the signature of each individual on whose behalf Trading Partner submits transactions, certifying that Trading Partner is so authorized.
(c) Trading Partner will ensure that every electronic entry can be readily associated and identified with an original source document. Each source document must reflect the following information: individual’s name; individual’s health insurance identification number; date(s) of service; diagnosis/nature of illness; and procedure/service(s) performed.
(d) Trading Partner will affix the Parent Company assigned unique identifier number of the Provider on each claim electronically transmitted to Parent Company in the appropriate data segment.
(e) Trading Partner will limit the number of claims in a single ST to SE segment to a maximum of 5,000.
(f) Trading Partner will transmit claims placing Trading Partner’s submitter number at the ISA 06 (Interchange Sender ID), GS 02 (Application Senders Code) and at the Loop 1000A NM109 (Identification Code). This means that a clearinghouse or billing agent’s submitter number will be populated in the ISA 06, GS 02 and Loop 1000A NM109 unless a business need has been identified by either the original provider of services or Parent Company.
(g) Should a trading partner, Provider of services or Parent Company identify a business need, the sender of claims, i.e. the clearinghouse or billing agent, must transmit a separate file for each trading partner so identified using the clearinghouse or billing agent’s submitter number populated in the ISA 06, GS 02 and the individual Provider trading partner’s submitter number in the 1000A NM109.
(h) It is the Trading Partner’s obligation to review all EDI reports supplied by Parent Company and to contact Parent Company regarding any discrepancies identified.
(i) Trading Partner will notify Par...
Trading Partner Obligations. In addition to the requirements of Section 3.1 and 5.1 and this section (3.2), the Trading Partner shall also be specifically obligated as follows:
Trading Partner Obligations. The Trading Partner agrees to the following:
3.1 Trading Partner xxxxxx agrees that it will not change any definition, data condition or use of a data element or segment as proscribed in the HHS Transaction Standard Regulation (45 C.F.R. § 162.915(a)).
3.2 Trading Partner xxxxxx agrees that it will not add any data elements or segments to the maximum data set as proscribed in the HHS Transaction Standard Regulation (45 C.F.R. §162.915(b)).
3.3 Trading Partner hereby agrees that it will not use any code or data elements that are either marked “not used” in the Standard’s implementation specifications or are not in the Standard’s implementation specifications. (45 C.F.R. §162.915(c)).
3.4 Trading Partner xxxxxx agrees that it will not change the meaning or intent of any of the Standard’s implementation specifications. (45 C.F.R. §162.915(d)).
3.5 Trading Partner hereby understands and agrees to submit to ASES specific data elements in accordance with the GHP Guides to the extent that GHP specific data elements do not change the meaning or intent of any of the Standard’s implementation specifications (45 C.F.R. §162.915(d)) or do not change any definition, data condition or use of a data element or segment as proscribed in the HHS Transaction Regulation (45 C.F.R. §162.915(a)).
3.6 Trading Partner agrees to cure Transactions errors or deficiencies identified by XXXX.
3.7 Trading Partner agrees and understands that, from time to time, the federal Department of Health and Human Services (“HHS”) may modify and set compliance dates for its Standards. Trading Partner agrees to incorporate by reference into this TPA any such modifications or changes. (45 C.F.R. §160.104).
3.8 Trading Partner and ASES understand and agree to keep open code sets being processed or used in this TPA for at least the current billing period or any appeal period, whichever is longer. (45 C.F.R. §162.925(c)(2)).
3.9 Trading Partner agrees to meet all state and federal laws and regulations pertaining to confidentiality, privacy and security that are applicable to the Parties and to maintain and safeguard, in accordance with all state and federal laws and regulations, the confidentiality of ASES data and the’ personal, financial and medical information of ASES’s beneficiaries.
