I have a custome that is the TPA (third party administrator) for a large company for managing their retirees medical and drug benefits. The TPA has an R:base database with all of the retirees dependents, and what medical and drug benefits they get. The TPA collects the money from the retirees every month for the premiums for the plans they are in.
My customer, the TPA, sends an eligibility file (834) to the medical insurance companis and the drug beneft company with a list of all the employees and dependents that are eligible to receive coverage on that plan. They alse send the insurance company a check for those members. They send a file every month. The insurance companies load that file into their systems and now doctors can call the insurance company and find out if the member is covered or not. The doctors will bill the insurance company. There are other HIPAA formats for this piece also. Troy -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Bob Castanaro Sent: Thursday, August 21, 2003 5:28 AM To: RBASE-L Mailing List Subject: [RBASE-L] - Re: HIPAA 834 Troy, What exactly is the 834 eligibility file format? How is it incorporated into R:Base? Thanks Bob "Troy Sosamon" <[EMAIL PROTECTED]> on 08/20/2003 12:18:33 PM Please respond to [EMAIL PROTECTED] To: [EMAIL PROTECTED] (RBASE-L Mailing List) cc: (bcc: Bob Castanaro/BCH) Subject: [RBASE-L] - HIPAA 834 I don't know if anyone else is interested in this or not, but I almost have the HIPAA 834 eligibility file format completly programmed. Troy Sosamon [EMAIL PROTECTED]
