Jim
Yes, the 277 unsolicited would be another avenue particularly if you used it as
your routine front-end acknowledgement transaction.  Here at UHIN we're getting
ready to fire up a 4020 version of it (the WG is now on the 4040 version; UHIN
needed to implement now (you know how that goes) so we decided to do 4020 but
4040 is definitely an improvement over 4020).  If you were to send a 277
front-end acknowledgement (277FE) for ALL your claims the providers would be
routinely reading them. You could reject such claims on the front-end (if your
system can do so) and that would save you from bringing them in and having to
issue an 835 on the back end.

Just an idea.  I know providers LOVE the 277FE. It's detailed, all the payers
using it use the same codes (providers now face the problem that everyone uses
different accept/reject codes - acknowedgements are really a nightmare to
decipher!) - in our tests it seems to work quite well.  I think NCVHS is
considering recommending that the 277FE be included in the HIPAA-2 suite of
transactions.

Jan Root

"J.G." wrote:

> I think we may try to go ahead with Mike's or Jan's suggestion of using
> either the 101 or 110 adjustment reason code initially.  I'm concerned that
> these will result in phone calls instead of conveying what we really want to
> convey.  The 101 suggestion seems to indicate that we expect to pay $0 when
> we may actually pay something when the claim is filed. But this was also
> what we came up with.  The 110 may make it seem that we thought it was a
> claim instead of a predetermination, but may actually get the point across
> to some of the providers.
>
> Therefore we will probably go ahead and request a new code, and when/if it's
> issued we will simply have to make a quick update to a table on our system.
>
> My concern about unsolicited claims status is that from experience there are
> many providers who never look at it, and again there's the same issue that
> they won't really be informed that we don't do predeterminations and will
> call instead.  However, it's a good point to consider since our system will
> create entries on a database so that we can respond to a solicited claims
> status, and we will need to decide what claims status codes are most
> appropriate.
>
> Thanks for all the suggestions.  It was helpful to see that people seemed to
> go through similar thought processes when looking at this.
>
> Jim Griffin
> Business Systems Analyst
> CNA
>
> -----Original Message-----
> From: Falbowski, Ellen [mailto:[EMAIL PROTECTED]]
> Sent: Wednesday, January 16, 2002 11:48 AM
> To: '[EMAIL PROTECTED]'
> Subject: RE: Predetermination of Dental Benefits
>
> Couldn't this be also handled via the unsolicited 277 claim status?  The
> STC01 could carry E0 (Error in submitted request data) or A3 (Returned as
> unprocessable) in the Category Code and 187 (Date(s) of service) in the
> Status Code.
>
> -----Original Message-----
> From: Jan Root [mailto:[EMAIL PROTECTED]]
> Sent: Wednesday, January 16, 2002 2:17 PM
> To: [EMAIL PROTECTED]
> Subject: Re: Predetermination of Dental Benefits
>
> Jim
> You are correct that there is not a good way to do this in the 835.  You
> might
> try using code '110 - Billing date predates service date' in the claim level
> CAS
> but I can see that it would be quite a stretch....
>
> I would suggest that you contact the Codes Maintenance Committee and request
> a
> new Adjustment Reason Codes. You might also want to request a new Claim
> Status
> Reason Codes if you think you might need this to respond to a claim status
> inquiry (the same committee handles both code lists).  This could be a
> pre-adjudication rejection.  Requests for new codes can be made at
> http://www.wpc-edi.com/conferences/crc.html.  Login and go to the February
> 2002
> Issues and Agenda topic under Issues & Requests (you might have to hit the
> 'more'
> button at the bottom of the list).
>
> j
>
> "J.G." wrote:
>
> > Our plan includes both medical as well as limited dental coverage.  We do
> > not do any predetermination of benefits today.  If a provider calls in we
> > tell them we don't predetermine benefits.  If they send in a paper form we
> > respond with a form letter telling them we don't predetermine benefits.
> If
> > they ask specific questions on the phone, they may get some additional
> > information, but nothing that should be close to an actual
> predetermination.
> >
> > The 837 Dental Claim transaction allows for a predetermination request.
> The
> > 835 Remittance Advice allows for a response.  However, I don't see a way
> to
> > indicate that we don't perform predeterminations.  Is there a way to do
> this
> > in the 835, or is there another way to respond to this?
> >
> > Jim Griffin
> > Business Systems Analyst
> > CNA
> >
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