----- Original Message -----
From: PC Help <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Monday, August 07, 2000 11:57 PM
Subject: Need X12 Transaction Set for Health Care Provider
> Does anybody know of a transaction set that will handle both Health Care
> Provider and Fee Schedule information. Some of the data that it needs to
> contain is provider demographics, speciality code, fed id, certification,
> malpractice, contract no., negotiated rate, pay, R&C HIAA, RVS, and
> procedure code.
Hmm, I only looked through ANSI 003051, but could not find any one
document....but...although your application is healthcare, let me suggest
two documents used in manufacturing/distribution:
The 816 Organizational Relationships would be the perfect document to
transmit information about providers, but does not really lend itself to
providing fee schedules...
.. and ...
The 832 Price/Sales Catalog would be perfect for fee schedules. It is set up
for "item numbers" (CPT-4 and HCPCS procedure codes), plus there are places
for price basis
(CTP and G93 segments) and numerous reference numbers (REF segments and N1
Loops).
Even though you asked for one, two documents might make more sense here: you
are transmitting two different types of information (static info on
providers and current fee schedules) and likely have two different end-users
(provider maintenance and billing) at the destination.
Hell, it's a thought.
Michael C. Mattias
Tal Systems
Racine WI
[EMAIL PROTECTED]
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