Thanks Mike. It's funny I have spent most of my EDI career in Supply Chain and Logistics. This is my first time venturing into healthcare.
Dylan On Wed, Oct 24, 2012 at 4:40 PM, Michael Mattias/LS < [email protected]> wrote: > 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<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! 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