10/24/12 >I wanted to inquire a little further about the REF*6R. In seems that if we >send a unique number in the REF*6R in the CLM(loop 2300)-LX( loop 2400) REF >we should get a REF*6R back in the SVC Loop 2110 Correct? If we have >multiple LX loops can the REF*6R still be the same in each one?
Yes. You should get back whatever you send in the 2400 LX loop of the '837' in the 2110 SVC loop of the '835' If you send a loop LX without a REF*6R IN THAT LOOP you will not get a REF*6R in 2110 SVC. It's a payer-is-required-to-turnaround data element from '837' to '835.' It's identified as "Line ItemControl Number" (and we probably spent a lot of our tax dollars on some consultant who came up with that clever name) There is no restriction on the value in REF02 (REF01=6R) other than size - I think it's limited to 12 in X09x even though ANSI 004010/005010 max size is, I think, 80. Check the IG I can't remember this stuff off the top of my head anymore. (Haven't you heard? I'm out of healthcare (except for sales of PPPS) ! Supply Chain is where I live now). Michael C. Mattias Tal Systems Inc. Racine WI [email protected] ----- Original Message ----- From: "Dylan Hall" <[email protected]> To: "Michael Mattias/LS" <[email protected]> Sent: Wednesday, October 24, 2012 1:27 PM Subject: Re: [EDI-L] Matching Incoming 835 with Outgoing 837 [good response with shameless marketing added] Hello Michael, I wanted to inquire a little further about the REF*6R. In seems that if we send a unique number in the REF*6R in the CLM(loop 2300)-LX( loop 2400) REF we should get a REF*6R back in the SVC Loop 2110 Correct? If we have multiple LX loops can the REF*6R still be the same in each one? Dylan On Tue, Oct 16, 2012 at 6:57 PM, Michael Mattias/LS < [email protected]> wrote: > 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 > > > > ------------------------------------ ... 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/
