I would strongly recommend against modifying any transaction set you receive from a submitter for pretty pragmatic risk management reasons. As far as the submitter is concerned, they sent you a batch of claims in the 837 - and without any formal acknowledgement indicating acceptance or rejection and why, they will most surely assume that you indeed receive and are processing all of the submitted claims. Sure, technically you can use any text editor that can properly handle a binary file - if you know how to read the raw X12 data stream. UltraEdit is one such text editor - as is Notepad. But, more properly, if the error is a violation of either X12 syntax or the HIPAA 837 implementation guide, you should truly reject it back to the originator with a proper error message: either the 997 (for syntax errors), or a 277 for claims acknowledgment or even an 824 - or something. By modifying the received transaction set you do not give the submitter any knowledge of the error nor an opportunity to take appropriate corrective action - and then re-submit. And to also then make whatever internal changes necessary so that they do not continue to repeat the error into the future in other transaction sets. Rachel
Rachel Foerster & Associates, Ltd. 39432 North Avenue Beach Park, IL 60099 Voice: 847-872-8070 Fax: 847-589-8081 _____ From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Mike Rawlins Sent: Thursday, April 28, 2005 2:51 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> > > > > > _____ > >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 > > > > --------------------------------------------------------------- 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 _____ 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] <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 <*> 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! 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