Juliet,
Have you considered making a change to your claims repricing system in
order to reprice claims with multiple rendering providers?
Kepa
Juliet Mees wrote:
>
> During our mapping of the 837 we have encountered an issue with the fact that one
>claim can have different rendering providers at the claim detail level. As an access
>only PPO our main function is to perform claim re-pricing and then forward these
>repriced claims to the appropriate payers for payment.
>
> Our claims transaction system only allows one provider contract per claim for
>repricing, so are we allowed to split the claim when the rendering provider changes
>and send out multiple claims to our payers when different rendering providers are
>received in the detail segment (Loop 2420A)?
>
> Any guidance is much appreciated?
>
> Juliet Mees
> Director, Technology Compliance
> Sloans Lake Managed Care
> 303-504-5350
> [EMAIL PROTECTED]
>
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