RE: 271 Unsolicited

[Owens, Kris]

Title: 271 Unsolicited

Help my organization be clear the issue of the 271 Unsolicited roster.    The regulations mandate the 270/271 request/response pair, not the unsolicited roster    Subpart L—Eligibility for a Health Plan § 162.1201 Eligibility for a health plan transaction. The eligibility for a health plan transaction is the transmission of either of the following: (a) An inquiry from a health care provider to a health plan, or from one health plan to another health plan, to obtain any of the following information about a benefit plan for an enrollee:     (1) Eligibility to receive health care under the health plan.     (2) Coverage of health care under the health plan.     (3) Benefits associated with the benefit plan. (b) A response from a health plan to a health care provider’s (or another health plan’s) inquiry described in paragraph (a) of this section. § 162.1202 Standards for eligibility for a health plan.The Secretary adopts the following standards for the eligibility for a health plan transaction: ...  (b) Dental, professional, and institutional. The ASC X12N 270/271– Health Care Eligibility Benefit Inquiry and Response, Version 4010, May 2000, Washington Publishing Company, 004010X092. The implementation specification is available at the addresses specified in § 162.920(a)(1).      So.... am I correct in assuming that even if the 271 Roster is finalized, the HIPAA standards for transactions will still have to be revised to require the roster as a mandated standard?  (Not that using the 271 roster isn't a good idea...)   In other words, once the guide has passed the final proofing phase and is published does not infer a change in the mandated transactions?  Are we interpreting this correctly?   thanks,   Kris Owens Senior IS Project Manager - HIPAA Project 505.923.8108 [EMAIL PROTECTED] "You don't know what you can get away with until you try"  General Colin Powell   -----Original Message----- From: Stuart Beaton [mailto:[EMAIL PROTECTED]] Sent: Friday, April 12, 2002 6:13 PM To: [EMAIL PROTECTED] Subject: RE: 271 Unsolicited The Unsolicited Health Care Eligibility/Benefit Roster 271, version 004010 Implementation Guide (X040) is currently in its final proofing phase.  The guide should be published prior to the June X12 meeting (possibly sooner).   Stuart Beaton Vice President Washington Publishing Company Co-Chair X12N/TG2/WG1 - Health Care Eligibility -----Original Message----- From: Grant, Dana [mailto:[EMAIL PROTECTED]] Sent: Fri 4/12/2002 1:04 PM To: '[EMAIL PROTECTED]' Cc: Subject: 271 Unsolicited Is anyone in the group aware of how close the 271 Unsolicited Health Care Eligibility/Benefit Roster guide is to becoming final? The Washington Publishing Company has this transaction listed with a status of Review 2. Any information the group may have is appreciated. Thanks, Dana Grant Business Analyst/HIPAA-EDI Coventry Health Care E-mail:   <Mailto:[EMAIL PROTECTED]> Phone:   724-778-3782 Fax:       724-778-4284 Coventry Health Care has a new look on the internet! 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