OK, what's the deal with the listserv? I've gotten this message about seven (7) times now. Is it just me?
-----Original Message----- From: Martin Scholl [mailto:[EMAIL PROTECTED]] Sent: Wednesday, June 26, 2002 11:12 AM To: [EMAIL PROTECTED] Subject: Re: Real Time overflow Thanks Alan, Now I get it too. And I agree with you that in order to uniquely define a claim, we should have the provider's claim # (CLM01) as a required field. REF*1K could be interpreted as this. The Member ID is a mandatory field for the subscriber level. This will narrow down a search. A bold solution to a query that returns more then 99 possible matches would be to use a Claim Status Category "A4 Acknowledgement/Not Found" and a claim Status of "0 cannot provide further information electronically". 99 + responses also sends a lot of PMI over the ether whereby 99% of it is useless. Think of the poor provider who has to wade through all this information. While we are mulling over the structure of the 276, why is there contact information for the information source, but not for the receiver? It would make more sense to be able to provide contact info for the requestor, so that a payer who wants to communicate directly with the requestor, has the necessary info. The 270 has this solved more logically. There is no provision for the information source's contact info, but for the receiver's. Martin Scholl Scholl Consulting Group, Inc. 301-924-5537 Tel 301-570-0139 Fax [EMAIL PROTECTED] www.SchollConsulting.com ----- Original Message ----- From: "Hirth, Alan" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, June 26, 2002 10:42 AM Subject: RE: Real Time overflow > > Actually, I do get your question. We have a whole log dedicated to it. We > are allowing search options which in a case of "claims from a provider for a > certain date" can result in many hits for a provider. I look forward to any > solutions out there. Aside from the REF-BLT for institutional we are > thinking about requiring the member id and date of service which are both > required for the 837 so should be known. For those using services we are > floating a few other ideas to keep the inquiry restrictive: > > - Questionable use of REF qual 1K. Payer claim number is useless and > unknown. The annotation points to the submitters claim number from > 837-CLM01. If we require either the CLM01 value or the patient ID number > for a date or restricted date range we can assure <99. > > - Require the patient's ID from the 837. > > - In the TPA or partner specific companion document (imp guide) note that if > they get 99 there's a good chance there are some missing. > > If your realtime is a DDE the concepts will still be similar because the > content is the same. > > -----Original Message----- > From: Martin Scholl > To: [EMAIL PROTECTED] > Sent: 6/26/02 10:25 AM > Subject: Re: Real Time overflow > > I don't get your problem. > A single inquiry means a single claim? > or are you thinking of a 276 with more then 99 individual claim > inquiries? > You could limit the number of inquiries within a single 276 to 99 in a > trading partner agreement. > You could reject a 276 with more then 99 claim inquiries based on this > agreement. > > Or are you thinking about a 277 with more then 99 STC segments? > > Martin Scholl > Scholl Consulting Group, Inc. > 301-924-5537 Tel > 301-570-0139 Fax > [EMAIL PROTECTED] > www.SchollConsulting.com > > > ----- Original Message ----- > From: "Bradford, Ryan D" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Wednesday, June 26, 2002 9:30 AM > Subject: Real Time overflow > > > > How does one report an excess of responses from an inquiry? > > > > We are building a real time solution for the 276/277 transaction. We > are > > using a Web page for a real time application and would limit the > number of > > responses to a single inquiry to 99. We can control this through the > web > > environment, but how do we let the Trading Partner know that there > were > more > > the 99 responses within the 277? I have searched everywhere and can > not > come > > up with any ideas. All responses are appreciated. Thank you. > > > > > > Ryan Bradford > > EDS - Provider Services > > 155 Federal Street, 6th Floor > > Boston, MA 02110 > > > > * phone: +01-617-350-8073 > > * fax: +01-617-350-8180 > > * mailto:[EMAIL PROTECTED] > > > > > > > > > > > > ********************************************************************** > > 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. 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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. ********************************************************************** 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.
