Chris,
First of all you do not have to send the 4010 format to your repricer. This
can be a proprietary format that you have used in the past. This is not a
covered transaction and the repricer is not a covered entity.
As far as tracking the information, I don't think the transaction/codesets
NPRM would cover that. You may have issues with privacy or security.
Thank you,
Terry Christensen
[ IS Administration Simplification EDI
Telelphone: (402)351-6370
Fax: (402)351-8025
e-mail: [EMAIL PROTECTED]
"Graff,
Chris" To: "Transactions (E-mail)"
<cgraff@uwsi. <[EMAIL PROTECTED]>
com> cc:
Subject: FW: How much tracking of the
ANSI
09/26/2001 4010 837 has to be done?
01:24 PM
Please
respond to
transactions
Thanks for the wonderful response to my previous question. I am sure that
I
will stump you folks at some time. In fact, I have another tough one for
you.
We are clearinghouse that keeps track of large sums of claims. We will be
submitting and receiving transactions from many different payers,
providers,
and other entities. During the course of these transactions the 4010
format
will be used for any transmissions coming and going out of the database.
My question is do we have to keep track of exactly how the data was batched
for each 4010 that was sent to each one of these entities?
For instance, we might submit a 4010 to a repricer, for which they will
submit data with altered prices back to us. Then we might submit this data
to a payer, in which some of the claims that were repriced may be in that
batch as well. Between the two sets, different claims were used for
different batch types, and data may have been changed in the process. I am
sure that we have to keep track of what data was changed, but to keep track
of exactly what elements were sent to each individual entity, per each
claim, per batch seems a bit much. Do we need to store this much
information or can we just store changes to the original claim? What are
your thoughts.
Thank you,
Chris Graff
United Wisconsin Proservices
(414)226-6022
800-822-8050 x6022
[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]>
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