Allen, Payment/Remittance advice is likewise defined as from a plan to a provider or provider's financial institution so this transmission does not meet the definition. 162.1601
Likewise, a claim status inquiry is defined as an inquiry to determine the status of a claim. Since, as you indicated below, the request for payment between providers is not a "claim", an inquiry about it is not a claim status. 162.1601 Hope that helps! Leah Hole-Curry Fox Systems, Inc. >>> "McCall, Allen" <[EMAIL PROTECTED]> 02/12/02 18:53 PM >>> Situation: A Sate funded Mental Hospital takes one of its inpatients to be treated by a physician for the flu. The physician bills the hospital. The hospital pays the physician. NO plans/payers are involved. Issue: This does not meet the definition of a claim because a claim is defined as between a provider and a plan (see the rule section 162.1101). But what about a Claim Status and a Remittance Advice? Allen McCall Sierra Systems 711 Capitol Way SE, Suite 304 Olympia, WA 98501 Telephone: (360) 357-5668 Mobile: (425) 894-0790 Fax: (360) 754-0480 [EMAIL PROTECTED] http://www.sierrasystems.com This electronic message is intended only for the use of the addresse(s) named above and may contain legally privileged and/or confidential information. If you are not the intended recipient of this message, you are notified that any dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, please notify the sender by telephone and delete the original message. Thank you for your cooperation. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address.
