Robert,

I agree with your perspective and that this is one of the issues that
standardizing both format and content HIPAA is attempting to solve.

Rachel

-----Original Message-----
From: Robert Barclay [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, October 16, 2001 9:54 AM
To: [EMAIL PROTECTED]
Subject: RE: Code Editing


I, too, have concerns about rejecting entire transactions but I do not see
it as an unresolvable problem.  First of all, today's EDI rejections do not
equate to tomorrow's HIPAA "non-compliance" rejections.  A 10% rejection
rate today will not mean most HIPAA transaction will be rejected in the
future.  Many of the reason's payers reject transactions today are related
to business needs or proprietary format usage.  Under HIPAA payers can not
"reject" compliant transaction that don't meet their business needs nor can
they dictate their own special segment usage.  Payers don't have to
adjudicate the claim to the submitter's liking but they can't reject it
without processing it first.

Second, I think the concept of batches will return.  The HIPAA claims are
sent in transactions (ST to SE) having up to 5000 claims.  The paper related
concept of batch does not exist.  Smart submitters, I suspect, will catch on
that multiple smaller transactions will limit their compliance rejection
liability.  I can see transactions with 100 to 500 claims each as the future
norm.

Third, HIPAA allows more options to reject/deny input.  Unlike today,  where
payers usually reject in EDI or deny in adjudication, HIPAA permits a more
tiered approach.  I said "allows" and "permits" because, except for the 835,
these ANSI transaction are not mandate by HIPAA.  Here is my current
understanding of the rejection/denial transactions usable with an 837
transaction.

TA1  -  This can reject the entire "file" if there is a problem with the ISA
(i.e. a file sent it to the wrong payer.)
997   -  This can reject an entire transaction (ST to SE) for X12N format
problems before claims processing.
824(or 997?)  -  This can reject an entire transaction for HIPAA compliance
issues before claims processing.
Unsolicited 277  -  This can reject an individual claim for business related
issues during claims processing.
835   -   This reports payment denial resulting from claims processing.

Although the picture is not altogether clear, I think submitters and payers
will achieve a workable balance under HIPAA.  Payers will accept more data
will business problems.  Submitters will pay a higher price for format
mistakes.  Both parties will learn to communicate in a different manner.

Robert Barclay
EDS - Wisconsin Medicaid HIPAA Team
[EMAIL PROTECTED]
(608) 221-4746 x3323


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