The 837 and 835 are independent transactions. A provider may send all, some
or none of their claims via the 837. Also, they may choose that all of their
remits be sent back via the 835. What is important to understand is that a
provider could be sending paper claims and receive back an 835.. that is
perfectly within their rights under HIPAA. Currently, the only way to know
whether or not to send/receive any transaction is for the two trading partners
to talk. Personally, I hope we can find a more automatic way to do this but
in the short term this is what you will need to do
I hope that helps
Jonathan Showalter
Omaha NE USA
402-343-3381
[EMAIL PROTECTED]
------------------( Forwarded letter 1 follows )---------------------
Date: Thu, 25 Oct 2001 08:29:52 -0500
To: transactions.wedi.org[transactions]@wedi.org
From: Tarry.Hauser[THauser]@mahealthcare.com
Sender: [EMAIL PROTECTED]
Reply-To: [EMAIL PROTECTED]
Subject: Issue from a recent conference
"There did not seem to be a definite answer on how we know that we should
send an 835 transaction back when we receive an 837. At one point there was
to be a routing # if the Provider wanted the 835 back. However, there is
nothing in the data field such as a routing # to know."
This question cam back to me after one of our own attended an SPBA
conference. Do we have an answer for this anywhere in the regs?
Tarry L. Hauser
Applications Specialist
Medical Associates Health Plans
700 Locust Street Ste 230
PO Box 5002
Dubuque, IA 52004-5002
(319)584-4830
FAX (319)556-5134
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