I agree, it is a very difficult proposition. If it is a dependant that has a bad service line, you need to back out the dependant. If there was only one dependant, and the subscriber had no claim, you need to back out the subscriber. You need to perform this kind of activity at each step of the process, including the envelopes. Since there was a specific request for such a process or tool, AXIOM has a tool that provides this functionality. Please contact me off-list for additional information. Pete
-- Pete Austin Vice President, eCommerce Services AXIOM Systems, Inc. The Managed Care Systems Experts 20300 Century Boulevard, Suite 120 Germantown, MD 20874-1110 www.axiom-systems.com <http://www.axiom-systems.com/> 301 840 3861 x210 240 605 6939 cell 240 465 0051 fax [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> ________________________________ From: [email protected] on behalf of [EMAIL PROTECTED] Sent: Thu 4/28/2005 3:18 PM To: [EMAIL PROTECTED]; [email protected] Subject: RE: [EDI-L] how to remove a "claim" from an X12 837 data file Mike... I don't follow when you say what I advised would be inaccurate. I mentioned the need to back out ISA, IEA, GS and GE's (If there is a single ST/SE pair). Thanks, Martin Morrison -----Original Message----- From: Mike Rawlins [mailto:[EMAIL PROTECTED] Sent: Thursday, April 28, 2005 12:51 PM To: [email protected] Subject: RE: [EDI-L] how to remove a "claim" from an X12 837 data file Actually, I would advise against this. The ideal situation would be for the processing application to be able to process the whole batch of claims in a single 837 TS, accept the good ones, and reject the bad ones. That is the only solution that makes sense. However, if you aren't able to do what makes sense, the directions below aren't accurate. If you're removing a single claim from within an 837 TS, you will not be concerned with counting ISA, IEA, GS or GE segments. Your scope will be entirely within one transaction set (starting with the ST and ending with the SE). Decrement the segment count in SE01 by the number of segments you have removed, and you should be OK so far as the basic syntax goes. I will let others address considerations for preserving compliance with 837 implementation guidelines, such as the HL loops mentioned in the previous reply. Mike At 12:31 PM 4/28/2005 -0700, Morrison, Martin wrote: >Troy... >There really aren't any "totals" to be reckoned with as there were in the >NSF and UB-92 layouts. >The only item along those lines that needs to be addressed is the SE01 >element which can be extrapolated by doing something like a global replace >of the Segment Terminator with the same value and getting a count of the >replaces. From that total back out any ISA,IEA,GS or GE segments. >Of course, that presupposes you don't have multiple ST/SE pairs in the >"file". > >The bigger issue is renumbering of the 2000 loop "HL" elements.. >Walking through the data from top to bottom to recalculate HL01, HL02 and >possibly HL04's is about the only way to get those corrected. > > > >Thanks, >Martin Morrison > >-----Original Message----- >From: evhorig [mailto:[EMAIL PROTECTED] >Sent: Thursday, April 28, 2005 12:13 PM >To: [email protected] >Subject: [EDI-L] how to remove a "claim" from an X12 837 data file > > >ladies and gents, > > I have a need to remove a "claim" from an >837 data file, then resubmit the data file >for processing. If all of the associated totals/counter >etc data field do not calculate correctly then the >modified data file will be rejected. > > If anyone has a process that they use to remove >a "claim" from an 837 data file (and modify the >corresponding counters/totals) or any other helpful >information/links, please send me email: evhorig @ yahoo . com > > Unfortunely some claims we get have errors that >can not be corrected so the 837 data file gets rejected. > By removing the offending claim and adjusting >the associated 837 data accordingly we can resubmit >the modified dtaa file and it will be processed. > > The question is what needs to be done to remove >the claim? > > If it helps, i have the ability to use a computer >to determine what loop every 837 data segment is in. > > Thanks, > Troy - evhorig @ yahoo . com > > > > > > >. >Please use the following Message Identifiers as your subject prefix: ><SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> >Access the list online at: http://groups.yahoo.com/group/EDI-L <http://groups.yahoo.com/group/EDI-L> ><http://groups.yahoo.com/group/EDI-L <http://groups.yahoo.com/group/EDI-L ><http://groups.yahoo.com/group/EDI-L> > > > > > > > _____ > >Yahoo! Groups Links > > >* To visit your group on the web, go to: >http://groups.yahoo.com/group/EDI-L/ <http://groups.yahoo.com/group/EDI-L/> <http://groups.yahoo.com/group/EDI-L/ <http://groups.yahoo.com/group/EDI-L/ <http://groups.yahoo.com/group/EDI-L/> > > > > >* To unsubscribe from this group, send an email to: >[EMAIL PROTECTED] ><mailto:[EMAIL PROTECTED]> > > >* Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service ><http://docs.yahoo.com/info/terms/ <http://docs.yahoo.com/info/terms/ ><http://docs.yahoo.com/info/terms/> > > . > > > > >[Non-text portions of this message have been removed] > > > >. >Please use the following Message Identifiers as your subject prefix: ><SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> >Access the list online at: http://groups.yahoo.com/group/EDI-L <http://groups.yahoo.com/group/EDI-L> > >Yahoo! Groups Links > > > > --------------------------------------------------------------- Michael C. Rawlins, Rawlins EC Consulting www.rawlinsecconsulting.com Using XML with Legacy Business Applications (Addison-Wesley, 2003) www.awprofessional.com/titles/0321154940 . Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Access the list online at: http://groups.yahoo.com/group/EDI-L <http://groups.yahoo.com/group/EDI-L> _____ Yahoo! Groups Links * To visit your group on the web, go to: http://groups.yahoo.com/group/EDI-L/ <http://groups.yahoo.com/group/EDI-L/> * To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> * Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service <http://docs.yahoo.com/info/terms/> . [Non-text portions of this message have been removed] . Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Access the list online at: http://groups.yahoo.com/group/EDI-L Yahoo! Groups Links [Non-text portions of this message have been removed] . Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Access the list online at: http://groups.yahoo.com/group/EDI-L Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/EDI-L/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
