RE: When is a claim a standard claim?

[Dwayne E. Cecil]

Please pardon me if my thought process is to simplistic, but here is my view on EDI claim rejections:   EDI is an attempt to automate and streamline a paper based process.  In a paper based system, if a provider mails 1000 billing forms (claims) to a payer, the payer is only going to return correspondence on the forms that have problems.  The payer is not going to return all 1000 paper forms (claims) because one of them is incorrect.     I see EDI the same way, why return all 1000 claims because one of them is bad?  As a patient, I would hate to know that my claim has not been processed because someone else's claim was coded wrong....   From the payer's point of view, I would hate to go to court and explain to a judge that a claim was not processed in a reasonable amount of time because another claim in the batch was bad....   Anyway, that's my two cents, for what is worth...         Dwayne E. Cecil Senior Consultant LANSA, Inc. tel. 865-376-3486 fax 865-376-3486 www.lansa.com   Did you know these public Web sites are built with LANSA?:   www.common.org www.theriviera.com www.chown.com www.itt-tds.com www.odysseycruises.com   Please note that it may take up to 72 hours to process your request. The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.