I will be in a training session for the remainder of today and will
return tomorrow morning.  
If you require immediate assistance on a new issue please contact the
help desk.

Thanks!

>>> "[EMAIL PROTECTED]" 04/11/02 13:55 >>>

I will be in a training session for the remainder of today and will
return tomorrow morning.  
If you require immediate assistance on a new issue please contact the
help desk.

Thanks!

>>> "[EMAIL PROTECTED]" 04/11/02 13:47 >>>

Hal,
I don't think that list serve signup is fully automated.  If that's
true,
then your request will be routed to the list serve manager or managers
who
will add you to the list.  Please be patient, since it is a manual
process.

In the remittance advice, the Line Item Control Number must be returned
if
received on the corresponding claim.  The purpose of the Line Item
Control
Number is to aid the provider in matching the response to the original
line
item.  For example, in Dental claims, the provider frequently performs
the
same procedure on multiple areas of the mouth.  Since the remittance
advice
only references the original procedure code, it would be difficult or
impossible to match the response to the line item.  Note that I'm not
even
considering the complications resulting from bundling or unbundling of
line
items here.

In the case of a claim status response, the service level response also
references the procedure code.  As in the remittance advice, the
procedure
code may not be sufficient to match the response to the original line
item.
It is the Line Item Control Number that is a convenience to the
provider.
It can also be a convenience to the health plan when requesting claim
status
for a specific line item.

Hope this helps.
Tom Drinkard
EDIT, Inc.
678-795-1251
[EMAIL PROTECTED]

  -----Original Message-----
  From: Hal Scoggins [mailto:[EMAIL PROTECTED]]
  Sent: Thursday, April 11, 2002 12:12 PM
  To: [EMAIL PROTECTED]
  Subject: Next 276/277 question





  Folks,

  In the 276, the REF segment entitled "Service Line Item
Identification"
(page 91 in the original "Final" IG) contains the Line Item Control
Number.
Note #2 for that segment states, "Required when available from the
original
claim. When the Information Receiver is the Provider, this is required
when
the number was assigned by the provider on the original claim."

  So let's step through a scenario. Suppose I receive a 276 containing a
Service Line inquiry with no Line Item Control Number. I search my
claims
and locate the Service Line in question. Lo and behold, I have a Line
Item
Control Number for the Service Line stored in my database! Which means
that
it had to come in on an 837, and had a Line Item Control Number assigned
by
the provider.

  If the Receiver Name information and the Service Provider Name
information
are the same, then am I bound by law to stop at that point and reject
the
Inquiry as non-compliant? That simplifies things for me, but it only
causes
delays for the party requesting the claim status, and all over a minor
technicality. (Sort of sums up a lot of these compliance issues, doesn't
it?)

  I think I understand the reason for requiring the Line Item Control
Number
to be sent if one exists; it makes it much easier to match to the claim
in
the Payer's database. But once I've managed to locate the claim without
it,
it seems silly to refuse to send back the information just because I now
find that they didn't send me some additional information that would
have
made my search easier.

  I'd be interested in anyone's thoughts on the matter.

  BTW, I registered with the 276/277 listserv (X12N, TG2, WG5), but have
not
yet been "accepted." It seems that one must justify their need to
participate in an X12 listserv.

  Hal Scoggins
  SBPA Systems, Inc.
  (281) 679-7272 x116


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The WEDI SNIP listserv to which you are subscribed is not moderated. 
The discussions on this listserv therefore represent the views of the
individual participants, and do not necessarily represent the views of
the WEDI Board of Directors nor WEDI SNIP.  If you wish to receive an
official opinion, post your question to the WEDI SNIP Issues Database at
http://snip.wedi.org/tracking/.
Posting of advertisements or other commercial use of this listserv is
specifically prohibited.


**********************************************************************
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 WEDI SNIP listserv to which you are subscribed is not moderated. 
The discussions on this listserv therefore represent the views of the
individual participants, and do not necessarily represent the views of
the WEDI Board of Directors nor WEDI SNIP.  If you wish to receive an
official opinion, post your question to the WEDI SNIP Issues Database at
http://snip.wedi.org/tracking/.
Posting of advertisements or other commercial use of this listserv is
specifically prohibited.




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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 WEDI SNIP listserv to which you are subscribed is not moderated.  The discussions 
on this listserv therefore represent the views of the individual participants, and do 
not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP.  If 
you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
Database at http://snip.wedi.org/tracking/.
Posting of advertisements or other commercial use of this listserv is specifically 
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