Agreed. But the point was to distinguish processing a claim from "paying" a claim. The fact that we process one does not mean we pay it.
I would also agree with the proviso mentioned earlier that not every claim will receive an 835 -- there are other transactions used for some denials. Ken Fody -----Original Message----- From: Michael Mattias/Tal Systems [mailto:[EMAIL PROTECTED]] Sent: Monday, May 06, 2002 7:42 AM To: ''WEDi/SNIP ID & Routing' ' Subject: Re: FW: Article ----- Original Message ----- From: Fody, Kenneth W. <[EMAIL PROTECTED]> > Today, we do accept claims for non-covered services and, assuming the > information we need to determine whether the benefit is covered or not is > present, we process those claims, and deny them. But, that means they are 'processed' (or in your language, "adjudicated"), which IMNSHO is all the submitter can ask. Any claim so denied should appear in the next '835' remittance sent to the submitter with the appropriate adjustment code(s). Michael Mattias Tal Systems, Inc. Racine WI [EMAIL PROTECTED] www.talsystems.com www.providerpaymentpartner.com CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you have received this communication in error, please do not distribute and delete the original message. Please notify the sender by E-Mail at the address shown. Thank you for your compliance.
