It is my understanding that the general rule allows sharing of the minimum information necessary for payment... Regardless of authorization status provided by the patient...
Now what that minimum may be is a totally different story and will probably vary from case to case... -----Original Message----- From: Thuppanna, Raj [mailto:[EMAIL PROTECTED]] Sent: Wednesday, February 13, 2002 6:52 PM To: [EMAIL PROTECTED] Subject: RE: 276 / 277 Claim Status Teresa, I have a similar problem when I receive claims. I am thinking of using the last name and date of birth as a last resort to identify the insured/dependent. As a payer I wonder why would you get a claim status? If you meant Claim status request, there are few claim status codes that you can use in your response to convey that you do not have enough/correct information to adjudicate the claim. Raj Thuppanna 770 444 4468 -----Original Message----- From: Howeth, Teresa [mailto:[EMAIL PROTECTED]] Sent: Wednesday, February 13, 2002 5:34 PM To: '[EMAIL PROTECTED]' Subject: 276 / 277 Claim Status As the Payor, we had not been doing EDI at all and went from no EDI to HIPAA compliant EDI. If a claim status is received and the Insured ID provided is invalid, do we have to provide the capability to search on names prior to responding? The reason I ask is because we have a unique number assigned to each Insured and we are not always provided with the correct Insured ID. Are we going to be required to accept in the transaction and search on name to locate the number prior to returning as not our Insured? I appreciate anyone who can assist. Thanks, Teresa Howeth, Business Analyst DP Admin [EMAIL PROTECTED] UICI http://www.uiciinsctr.com 817-255-3338 Office ********************************************************************** 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. ********************************************************************** 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.
