Re: Covered Transactions

[C.J. Major]

You kind of answered the question yourself.  HIPAA only governs the defined covered transactions.  If a transaction is a non-covered transaction, HIPAA does not govern what to use and how you send the transaction to anyone (covered entity or not).   CJ -------------------------------------------------------- C.J. Major Consultant - Comsys, Inc. Arizona Department of Health Services Division of Behavioral Health Services [EMAIL PROTECTED] T. 602.553.9082 F. 602.954-7259 --------------------------------------------------------     >>> [EMAIL PROTECTED] 1/15/02 4:15:09 AM >>> A covered entity (such as a provider) sends a non-covered transaction (such as a Workers' Comp claim) to a covered entity (such as a payer who services both Workers' Comp and other covered services) using a named transaction (such as the 837 professional version 4010) and uses code values that do not violate the 837 version 4010 standard, but are not covered in the HIPAA implementation guide.  The payer then sends an 835 version 4010 payment / remittance advice for the same transaction back to the provider, using code values that do not violate the 835 version 4010 standard, but are not covered in the HIPAA implementation guide for the 835 version 4010. Are either of the transactions or entities non-compliant anywhere in this process? Ken Steen VP, Information Systems Apollo Enterprises ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request.