I would echo what Rachel said and add that mis-identification of subscriber and
dependent happens all the time, today.  Patients are often unaware of whether
they are a 'dependent' or a 'subscriber' on a plan.  The provider submitting the
eligibility inquiry or claim takes their best shot at guessing.  Payers are free
to be strict and reject/deny transactions where the individual is
mis-identified, or to be more lenient and, if they can match the individual
somewhere in the member files, go ahead and process the transaction.  The
'price' of rejecting a transaction for misidentification will probably be a
phone call so it may be to the payers' economic advantage to persue a more
lenient policy, at least part of the time.

Jan Root

Rachel Foerster wrote:

> Alex,
>
> For something misidentified in this manner, you would have to make your own
> determination as to what response you would give back...but, again, I would
> think that if given the information provided on the inbound 270 you can be
> certain you've identified the correct individual in your system, why not
> return a meaningful answer. After all, the intent here is to avoid requiring
> the provider to make a phone call.
>
> In any case, it's still a business decision as to what you want to do in the
> scenario you describe.
>
> Rachel
>
> -----Original Message-----
> From: Alex Chernyak [mailto:[EMAIL PROTECTED]]
> Sent: Monday, April 29, 2002 10:30 AM
> To: [EMAIL PROTECTED]
> Subject: RE: Subscriber vs. Dependent
>
> And how about when the provider marks the subscriber as a patient (2100D)
> but submits the details for a dependent (2200E) or vice versa?
>
> >>> "Rachel Foerster" <[EMAIL PROTECTED]> 04/25/02 09:15PM >>>
> Jonathan,
>
> I'm sure/hope others here will also respond, but here's my take on your
> questions:
>
> 1. If the patient is NOT the subscriber, the patient HL should be created,
> even in the absence of knowing the member id for the patient. If the patient
> is the subscriber, then ONLY the subscriber HL should be created with as
> much identifying information as can be obtained, keeping in mind the minimum
> data required for subscriber/patient identification.
>
> 2. If the information source can accurately and unequivocally ascertain that
> the individual being queried about is the same individual in their system, I
> would recommend responding even if the individual is not the subscriber, but
> putting the individual's information in the appropriate HL structure.
>
> Of course, in both cases, you'd have to determine your own business rules
> for these responses, since the implications could be different if the query
> was for eligibility versus authorization/referral.
>
> Rachel
> Rachel Foerster
> Principal
> Rachel Foerster & Associates, Ltd.
> Professionals in EDI & Electronic Commerce
> 39432 North Avenue
> Beach Park, IL 60099
> Phone: 847-872-8070
> Fax: 847-872-6860
> http://www.rfa-edi.com
>
> -----Original Message-----
> From: Jonathan Fox [mailto:[EMAIL PROTECTED]]
> Sent: Thursday, April 25, 2002 5:13 PM
> To: [EMAIL PROTECTED]
> Subject: Subscriber vs. Dependent
>
> I have a question regarding the X12 transaction sets named under HIPAA that
> use the subscriber and dependent HL structure.  More specifically the
> inquiry/response transactions.
>
> If the information receiver (provider) does not know the patient's member
> id, how should they build the transaction set?  Should they put the patient
> information at the subscriber or the dependent level?
> Likewise, if the inquiry comes in at the subscriber level, and the member is
> NOT the subscriber, should we respond?
>
> Any guidance would be greatly appreciated!!!
>
> Jonathan Fox
> eCommerce Analyst
> Independent Health
>
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