Re: Replacing our current eligibility file with the 271

[Erin Harris]

Title: Replacing our current eligibility file with the 271

The 271 response to inquiry transaction is not intended to be used as a roster of eligibility, but only as a response to a 270 inquiry. If one were to use any of the transaction formats for that purpose, it would probably need to be something similar to the 834, with detailed coverage/eligibility information associated in some other way.   Depending on who your trading partners are, there may be some Privacy Rule issues with sending out unsolicited detailed eligibility rosters.   Erin Harris HIPAA Consultant [EMAIL PROTECTED] (925) 949-7933   ----- Original Message ----- From: Tatge, Ellen To: '[EMAIL PROTECTED]' ; '[EMAIL PROTECTED]' Sent: Tuesday, March 12, 2002 3:25 PM Subject: Replacing our current eligibility file with the 271 As part of our health plan implementation for HIPAA, we plan to begin using the 271 first as an unsolicited roster to replace the eligibility file we currently send to our trading partners.  During the process of mapping our current file to the 271, we have discovered that there are a number of fields we currently send to our trading partners that are not accomodated on the 271.  We are in the process of evaluating the affect of the absence of these fields on the process of doing business with our trading partners.  However, we are wondering if others are finding the same issues and what conclusions they are drawing. Examples of some of the fields not included in the 271 are: a transaction code indicating that the record is an add, update, term, or unchanged record. A relationship code indicating the member's relationship to the subscriber A termination reason code A product line indicator A current benefit package indicator Rider type code (multiple indicators) PCP provider group affiliation Other coverage carrier indicator Are other organizations encountering similar issues?  If so, how are you resolving them? Thanks, Ellen Tatge IS Project Manager Presbyterian Healthcare Services 505/923-6882 ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=siness and enter your email address. --- PRESBYTERIAN HEALTHCARE SERVICES DISCLAIMER --- This message originates from Presbyterian Healthcare Services or one of its affiliated organizations. It contains information, which may be confidential or privileged, and is intended only for the individual or entity named above. It is prohibited for anyone else to disclose, copy, distribute or use the contents of this message. All personal messages express views solely of the sender, which are not to be attributed to Presbyterian Healthcare Services or any of its affiliated organizations, and may not be distributed without this disclaimer. If you received this message in error, please notify us immediately at [EMAIL PROTECTED] ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address.