Doug,

The intended use of the HIPAA 278 guide (4010X094) is for request  for
health care services and associated response. A separate guide, the 278
Health Care Services Review - Inquiry and Response (4010X059) enables the
requester to inquire on the status of a health care services review (is
there an authorization/referral out there for this patient).  278 Inquiry
(4010X059) is not a HIPAA transaction.




"Darlene Peterson" <[EMAIL PROTECTED]> on 03/22/2002 07:11:24
AM

Please respond to <[EMAIL PROTECTED]>

To:   <[EMAIL PROTECTED]>
cc:
Subject:  Re: 278 Question


In the implementation Guide under the 2000F Service level, the UM01 element
gives you three choices AR - Admission Review (use to request admission to
a facility) we would use as a authorization request, HS - Health Services
Review (use to request for review of services related to an episode of
care) we would use as an authorization request or SC - Speciality Care
Review (use for a request for a referral to a speciality provider) we would
use as a referral.  If this line is sent in correctly it should state which
the sender is requesting.  This transaction is used to request and receive
a response for authorizations and referrals.

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>>> [EMAIL PROTECTED] 03/21/02 04:54PM >>>
We are now beginning work on the 278 Referral/Auth Transaction.  There
seems
to be some confusion as to what this transaction is all about.  Is it just
a
request for the status of a requested referral?  or can you actually
request
a referral and get an authorization back in a 278?  Any input would be
appreciated.

Doug Cassavar
Paramount Health Care



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