I have a question about submitter/receiver in a re-pricing model. In this example, we receive the claim for re-pricing. We are not destination payer.
According to 837 IG in the scenario where a provider (or providers billing service) sends the electronic claim to us for re-pricing, the provider is the submitter and we are receiver. We then re-price the claim and forward it to destination payer. Who should be the submitter and receiver when we forward the claim to payer? My understanding based on IG is that submitter and receiver should remain same when we forward the claim to destination payer. But It doesn't make sense for us to be receiver here. In the same model, it we get a paper claim from a provider and then forward the re-priced claim, who should be submitter and receiver? My understanding is that we are the submitter and destination payer is the receiver. Any help is appreciated Thanks Raj Thuppanna 770 444 4468 ********************************************************************** 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.
