Raj, I'm not seeing any traffic in "transactions" for a week, so possibly I fell off the list. But I'm curious to know how many of these situations you have encountered: required data elements in the 837 that cannot be sent to a CH (or billing service, repricer, etc.) in a "1500" format. I have heard that there are many fields that cannot be cross-walked between the CMS1500 and the 837, but I have not actually combed through the standard looking for them.
I have a real concern for the tens of thousands of small providers with systems only capable of producing CMS1500 claims. "Marrying" a clearinghouse would not seem to be a HIPAA solution for these folks unless they have enough basic HIPAA-awareness in their local OMS system to at least extract all the Required and Situational data elements from it. If the OMS vendors don't get their collective acts together, I don't see how the doctors will be able to comply with any of this. (SBR01 may just ve the tip of an ugly iceberg) -Chris At 06:06 PM 2/25/02 -0500, Thuppanna, Raj wrote: >I have a question about the field SBR01 - Payer Responsibility Sequence >Number Code in 837 (professional). This field indicates if the destination >payer is a primary, secondary or tertiary. > >This is a unique scenario where we (a re-pricer) get a HCFA claim on paper >and we forward the claim to destination payer as 837 after re-pricing. HCFA >paper claim does not carry any information that indicates if the payer is >primary, secondary or tertiary. (I know that UB paper claim does carry this >information). But SBR01 (Payer Responsibility Sequence Number Code) is a >required field on 837 professional. > >Is it ok for a re-pricer to convert the paper claim to 837? If so how do we >derive SBR01 from information on HCFA paper claim? > >Any help is appreciated > >Raj Thuppanna >770 444 4468 > > > >********************************************************************** >To be removed from this list, send a message to: [EMAIL PROTECTED] >Please note that it may take up to 72 hours to process your request. Christopher J. Feahr, OD http://visiondatastandard.org [EMAIL PROTECTED] Cell/Pager: 707-529-2268 ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address.
