The 276/277 IG does not cover the "pended" claim status function. Pended claim status notification is when the payer sends a "listing" of pended claims (unsolicited), not when they respond to the request for status (276). The 276/277 adopted by HHS for HIPAA claim status is not used for pended claim listing. See the front matter of the 276/277 IG, section 1.3:
"The 276 is used only in conjunction with the 277...Therefore this implementation guide addresses only the "paired" usage of the 276 as a request for claim status and the 277 as a response to that request. Maria Maria Ward PriceWaterhouseCoopers Healthcare Consulting Practice 312.298.2586 "Young, Brian" <[EMAIL PROTECTED]> on 02/22/2002 10:07:19 AM Please respond to [EMAIL PROTECTED] To: "'[EMAIL PROTECTED]'" <[EMAIL PROTECTED]> cc: Subject: RE: Notifying Providers of Pended Claims Dan, You really have no choice EDI wise. There is a specific Transaction Set (276/277 Health Care Claim Status Request and Response) covering your area of concern. BCY Brian C. Young Senior Software Engineer Accu-Med Services An OmniCare Company 300 TechneCenter Dr. Milford, OH 45150 -----Original Message----- From: Clark, Dan [mailto:[EMAIL PROTECTED]] Sent: Friday, February 22, 2002 10:46 AM To: [EMAIL PROTECTED] Subject: Notifying Providers of Pended Claims We currently notify Providers of their pended claims on our proprietary electronic remit. There is no allowance for that in the new 835. We are trying to decide whether or not continue this practice and if so, how? We are considering generating paper "letters" that would be mailed to providers. We are also looking at creating a separate proprietary electronic pend notification transaction. And as previously stated, we are also considering stopping the process of sending this information to Providers. I would appreciate hearing from anyone who has a similar dilemma and let me know how you are handling it. Thanks very much Dan Clark 804-678-0053 [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> ********************************************************************** 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. ---------------------------------------------------------------- The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you received this in error, please contact the sender and delete the material from any computer. ********************************************************************** 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.
