RE: FW: specialist

[Tom Drinkard]

Rajiv, In addition to the MSG segment, you could use the 2215C and 2120C loops at the Subscriber (or the corresponding 2215D and 2120D loops at the Dependent level.) The 2120C/D loop contains a PRV segment which can contain the Provider Taxonomy code.  In the Dental world, for example, some benefits must be performed by a ‘General Dentist’.  This can be expressed by using the Taxonomy Code for General Dentist, which is 122300000N.  The full segment would look like this: PRV*PE*ZZ*122300000N~   The first Usage Note for this segment (see page 261) says “Use this segment when needed to either identify a specific provider or associate a specialty type related to the service identified in the 2110C loop.”   Hope this helps.   Tom Drinkard EDIT (678) 795-1251 (voice) (678) 795-1575 (fax) [EMAIL PROTECTED]   -----Original Message----- From: Jan Root [mailto:[EMAIL PROTECTED]] Sent: Thursday, February 14, 2002 12:00 PM To: [EMAIL PROTECTED] Subject: Re: FW: specialist   Rajiv I don't know if there's any codified way to do it but there's alway sending plain text in the MSG segment.  I've been hearing that one way payers are implementing the 271 with minimal overhead is to cut-and -paste paragraphs from their member benefits book into the MSG segment and give that to providers. While it must be read by a human to be used, the providers I've talked with are ok with it (for now). Their systems aren't (yet) set up to handle the codified information and it sure beats a phone call, plus you have the information in writing. Anyway, not a very elegant solution but it would work. Jan Root "Sood, Rajiv" wrote:    Would anyone know if it's possible to pass a specialist copay back on a 271  (and if so, how) ?ThanksRajiv Thank you, Rajiv Sood, MBA HIPAA Implementation Manager Oxford Health Plans 48 Monroe Turnpike, Trumbull CT 06611 External Phone: 1-203-459-6913 Internal Phone: 8-204-6913 Fax: 1-203-459-6464 Email: [EMAIL PROTECTED] Toll Free: 1-800-889-7658 Ext. 6913 ********************************************************************** 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.