Common use of Electronic Data Interchange (EDI Clause in Contracts

Electronic Data Interchange (EDI. a. The Trading Partner agrees that this Agreement, among other items, constitutes a trading partner agreement as defined by 45 CFR 160.103 and governs the exchange of electronic health information between the Parties by Health Insurance Portability and Accountability Act of 1996 (HIPAA) standard transactions and permits appropriate disclosure and use of such information as permitted by law. b. The Trading Partner agrees to comply with all State and federal laws, rules, regulations and applicable policies, including without limitation the HIPAA (as amended), Sections 1171 through 1180 of the Social Security Act, Title 45 of the Code of Federal Regulation including Parts 160, 162, and 164, all applicable federal regulations, the electronic data transaction standards and code sets, the HIPAA Implementation Guides, and Medical Services’ Companion Guides. c. Prior to EDI and throughout the life of the Agreement, the Trading Partner’s electronic enrollment record will correctly indicate their desire to participate in EDI and the standard transactions authorized. d. The Trading Partner must require any entity with whom it contracts, and any subcontractors thereof, to comply with all applicable requirements and terms of this Agreement. e. The Trading Partner will obtain satisfactory assurance and documentation of the satisfactory assurance, as required under 45 CFR 164.502 (e), from any business associate with whom it contracts, and any subcontractors thereof, that it will appropriately safeguard the protected health information covered by this Agreement. f. The Trading Partner agrees and represents that it will disclose its Submitter ID number, password, and any other means that enable data to be transmitted to or received from Medical Services, only to intermediaries with who it has such Agreements or to members of its workforce, whom the Trading Partner has authorized to receive and transmit data on its behalf. g. Each party is responsible for all costs, charges, or fees it may incur by transmitting electronic transactions to, or receiving electronic transactions from, the other party. h. The Trading Partner shall not change the definition, data condition, meaning, intent or use of a data element or segment in a standard transaction; i. The Trading Partner shall not add any data elements or segments to the maximum defined data set, or use any code or data elements that are not in the standard transactions or are marked as “not used.” j. Each party is solely responsible for the preservation, confidentiality, and security of data exchanged as well as data in its possession, including data in transmissions received from the other party and will establish processes to limit access to those who need it to perform their duties and safeguard unauthorized access. k. The Trading Partner agrees and understands that there exists the possibility that Medical Services or others may request an exception from the Transaction and Code Set Regulations in whole or in part. If this occurs the Trading Partner agrees that it will cooperate and fully participate in the testing, verification, and implementation of a modification to the standard. l. The Trading Partner understands that the transaction standards and code sets may be modified and agrees that it will cooperate and fully participate in modifying, testing, verifying, and implementing the modifications or changes. m. The Trading Partner understands that it is responsible for following the Implementation Guides and Addendums as well as the DSS Companion Guides which are subject to change and will ensure that prior to initiating any EDI, the format specifications in the most current Guides are met. Failure to comply with the format specifications will result in the electronic claim or transaction being rejected and Medical Services will not be obligated to respond to the transaction. n. The data shall be and remain the property of Medical Services and the Trading Partner agrees that it acquires no title, rights, or interest to the data furnished by Medical Services, including de-identified information, as a result of the Agreement. o. Medical Services shall not be liable to the Trading Partner for any damage or expenses for damages in any amount incurred as a result of inaccuracies in any of the information, data, electronic files, or documents supplied.

Electronic Data Interchange (EDI. a. The Trading Partner agrees that this Agreement, among other items, Agreement constitutes a trading partner agreement as defined by 45 CFR C.F.R. § 160.103 and governs the exchange of electronic health information between the Parties by Health Insurance Portability and Accountability Act of 1996 (HIPAA) standard transactions and permits appropriate disclosure and use of such information as permitted by law. b. The Trading Partner agrees to comply with all State and federal laws, rules, regulations and applicable policies, including without limitation the HIPAA (as amended), Sections 1171 through 1180 of the Social Security Act, Title 45 of the Code of Federal Regulation including Parts 160, 162, and 164, all applicable federal regulations, the electronic data transaction standards and code sets, the HIPAA Implementation Guides, and Medical Services’ Companion Guides. c. Prior to EDI and throughout the life of the Agreement, the Trading Partner’s electronic enrollment record will correctly indicate their desire to participate in EDI and the standard transactions authorized. d. The Trading Partner must require any entity with whom it contracts, and any subcontractors thereof, to comply with all applicable requirements and terms of this Agreement. e. The Trading Partner will obtain satisfactory assurance and documentation of the satisfactory assurance, as required under 45 CFR C.F.R. § 164.502 (e), from any business associate with whom it contracts, and any subcontractors thereof, that it will appropriately safeguard the protected health information covered by this Agreement. f. The Trading Partner agrees and represents that it will disclose its Submitter submitter ID number, password, and any other means that enable data to be transmitted to or received from Medical Services, Services will only be disclosed to intermediaries with who whom it has such Agreements trading partner agreements or to members of its workforce, whom who the Trading Partner has authorized to receive and transmit data on its behalf. g. Each party is responsible for all costs, charges, or fees it may incur by transmitting electronic transactions to, or receiving electronic transactions from, the other party. h. The Trading Partner shall not change the definition, data condition, meaning, intent or use of a data element or segment in a standard transaction;. i. The Trading Partner shall not add any data elements or segments to the maximum defined data set, or use any code or data elements that are not in the standard transactions or are marked as “not used.” j. Each party is solely responsible for the preservation, confidentiality, and security of data exchanged as well as data in its possession, including data in transmissions received from the other party and will establish processes to limit access to those who need it to perform their duties and safeguard unauthorized access. k. The Trading Partner agrees and understands that there exists the possibility that Medical Services or others may request an exception from the Transaction and Code Set Regulations in whole or in part. If this occurs the Trading Partner agrees that it will cooperate and fully participate in the testing, verification, and implementation of a modification to the standard. l. The Trading Partner understands that the transaction standards and code sets may be modified and agrees that it will cooperate and fully participate in modifying, testing, verifying, and implementing the modifications or changes. m. The Trading Partner understands that it is responsible for following the Implementation Guides and Addendums as well as the DSS Companion Guides which are subject to change and will ensure that prior to initiating any EDI, the format specifications in the most current Guides are met. Failure to comply with the format specifications will result in the electronic claim or transaction being rejected and Medical Services will not be obligated to respond to the transaction. n. The data shall be and remain the property of Medical Services and the Trading Partner agrees that it acquires no title, rights, or interest to the data furnished by Medical Services, including de-identified information, as a result of the Agreement. o. Medical Services shall not be liable to the Trading Partner for any damage or expenses for damages in any amount incurred as a result of inaccuracies in any of the information, data, electronic files, or documents supplied.

Electronic Data Interchange (EDI. a. The Trading Partner agrees that this Agreement, among other items, constitutes a trading partner agreement as defined by 45 CFR 160.103 and governs the exchange of electronic health information between the Parties by Health Insurance Portability and Accountability Act of 1996 (HIPAA) standard transactions and permits appropriate disclosure and use of such information as permitted by law. b. The Trading Partner agrees to comply with all State and federal lawslaw, rulesrule, regulations regulation and applicable policiespolicy, including without limitation the HIPAA (as amended)HIPAA, Sections 1171 through 1180 1179 of the Social Security Act, Title 45 of the Code of Federal Regulation including Parts 160, 162, and 164, all applicable federal regulationsregulation, the electronic data transaction standards and code sets, the HIPAA Implementation Guides, and Medical Services’ Companion Guides. c. Prior to EDI and throughout the life of the Agreement, the Trading Partner’s electronic enrollment record will correctly indicate their desire to participate in EDI and the standard transactions authorized. d. The Trading Partner must require any entity with whom it contracts, and any subcontractors thereof, to comply with all applicable requirements and terms of this the Agreement. e. The Trading Partner will obtain satisfactory assurance and documentation of the satisfactory assurance, as required under 45 CFR 164.502 (e), from any business associate entity with whom it contracts, and any subcontractors thereof, that it will appropriately safeguard the protected health information covered by this Agreement. f. The Trading Partner agrees and represents that it will disclose its Submitter ID number, password, and any other means that enable data to be transmitted to or received from Medical Services, only to intermediaries with who it has such Agreements or to members of its workforce, whom the Trading Partner has authorized to receive and transmit data on its behalf. g. Each party is responsible for all costs, charges, or fees it may incur by transmitting electronic transactions to, or receiving electronic transactions from, the other party. h. The Trading Partner shall not change the definition, data condition, meaning, intent or use of a data element or segment in a standard transaction; i. The Trading Partner shall not add any data elements or segments to the maximum defined data set, or use any code or data elements that are not in the standard transactions or are marked as “not used.” j. Each party is solely responsible for the preservation, confidentiality, and security of data exchanged as well as data in its possession, including data in transmissions received from the other party and will establish processes to limit access to those who need it to perform their duties and safeguard unauthorized access. k. The Trading Partner agrees and understands that there exists the possibility that Medical Services or others may request an exception from the Transaction and Code Set Regulations in whole or in part. If this occurs the Trading Partner agrees that it will cooperate and fully participate in the testing, verification, and implementation of a modification to the standard. l. The Trading Partner understands that the transaction standards and code sets may be modified and agrees that it will cooperate and fully participate in modifying, testing, verifying, and implementing the modifications or changes. m. The Trading Partner understands that it is responsible for following the Implementation Guides and Addendums as well as the DSS Companion Guides which are subject to change and will ensure that prior to initiating any EDI, the format specifications in the most current Guides are met. Failure to comply with the format specifications will result in the electronic claim or transaction being rejected and Medical Services will not be obligated to respond to the transaction. n. The data shall be and remain the property of Medical Services and the Trading Partner agrees that it acquires no title, rights, or interest to the data furnished by Medical Services, including de-identified information, as a result of the Agreement. o. The Trading Partner acknowledges that criminal and civil penalties may apply for unapproved use of disclosure data. p. Medical Services shall not be liable to the Trading Partner for any damage or expenses for damages in any amount incurred as a result of inaccuracies in any of the information, data, electronic files, or documents supplied.