We would like to better understand the scope of the worker's compensation exception identified in the definition of health insurance issuer. Does this exception include all aspects of administering a worker's comp program (e.g. claims receipt, payment, notification, communications between payer and provider, etc.) or does it refer only to those administrative activities that process the claim (e.g. submitting to employer, notifying state agencies, etc.)?
As an example: 1) Does a worker's comp claim sent from a provider to a health plan have to follow the standard 837 transaction? 2) If a provider inquires about the status of a worker's comp claim, must the provider and the health plan follow the standard 276/277 transaction? Thank you for your time and consideration. Stacy Cruise ********************************************************************** 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.
