10/16/12 >I am working on an application for a client where they are sending out 837s >and receiving 835s. We would like to match the incoming 835 with the 837. > From my research thus far, I can see that the 837 CLM01 will contain >the "Patient account number” and the 835 CLP01 should be returned with this >number. Is this a correct assumption?
That's the way it's supposed to work. However, you'll also want to be reconciling at the service line level; for that you match on the REF*6R*valuehere segments in both the 835 and the 837. Note, however, this relies on the provider submitting all claims with a unique value in CLM01- not always true in my experience. Note too, be prepared for multiple remits with that "unique" number in CLP01 because payers often "revise" an earlier remittance and send a fresh '835' using that number. And as long as you brought it up....... How about something to store all the data elements of the '835' remittance in a database in discrete tables and columns you can access with all your favorite tools and/or techiniques? Check out The Provider Payment Partner(tm) System at http://www.providerpaymentpartner.com. I'm pretty sure you can't do what the PPPS can do - at least not for less than five hundred bucks.. and I have three or four "denial analysis" service bureaus doing just that right now. (Yes, of course it supports both X091 (004010) and X221 (005010) remits!) Michael C. Mattias Tal Systems Inc. Racine WI [email protected] ----- Original Message ----- From: "Dylan Hall" <[email protected]> To: "EDI-L" <[email protected]> Sent: Tuesday, October 16, 2012 5:30 PM Subject: [EDI-L] Matching Incoming 835 with Outgoing 837 Hello, Thanks Dylan [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> Job postings are welcome, but for job postings or requests for work: <JOBS> IS REQUIRED in the subject line as a prefix.Yahoo! Groups Links ------------------------------------ ... Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Job postings are welcome, but for job postings or requests for work: <JOBS> IS REQUIRED in the subject line as a prefix.Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/EDI-L/ <*> Your email settings: Individual Email | Traditional <*> To change settings online go to: http://groups.yahoo.com/group/EDI-L/join (Yahoo! ID required) <*> To change settings via email: [email protected] [email protected] <*> 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/
