Mike, Thank you for your feedback
Juliet
<<< "Winston, Mike K." <[EMAIL PROTECTED]> 8/16 5:11a >>>
Juliet, that is the approch we are taking.
Mike Winston
Trigon ISD
Ext 44521
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> -----Original Message-----
> From: Kepa Zubeldia [SMTP:[EMAIL PROTECTED]]
> Sent: Thursday, August 16, 2001 12:39 AM
> To: [EMAIL PROTECTED]
> Cc: James Driscoll; Ron Brunko
> Subject: Re: Rendering Provider Segment in 837 IG's
>
> 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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>
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