Jan, I did a bit of examination of the language in the 271 IG on the use of
the MSG segment as well as the discussion in Section 1.3.10 on disclaimers.
Here's my personal conclusions (and below I've inserted the relevant
portions of the IG):

I don't think that a description of a benefit is a disclaimer, if you look
at the dictionary definition of disclaimer. Furthermore, the MSG segment can
occur up to 10 times in the 271. Thus, using it to provide free-form text
description of the benefit itself doesn't, in my mind, constitute a
disclaimer statement.

But also note the requirement to provide codified information and if it's
not possible to do so, submit a change request to X12N via the DSMO process
so that you can provide codified information in the future. I would also ask
if you're sure that it's not possible to provide a codifed description of
the benefit you want to describe in free-form text.

Not sure this helps you out a lot....just my thoughts.

Rachel Foerster

American Heritage Dictionary:
disclaimer n. 1. A repudiation or denial of responsibility or connection. 2.
Law. A renunciation of one's right or claim.

Section 1.3.10 Disclaimers Within the Transactions
The developers of this Implementation Guideline strongly discourage the
transmission
of a disclaimer as a part of the transaction. Any disclaimers necessary
should be outlined in the agreement between trading partners. Under no
circumstances
should there be more than one disclaimer segment returned per individual
response.

2. Under no circumstances can an information source use the MSG
segment to relay information that can be sent using codified
information in existing data elements. If the need exists to use the
MSG segment, it is highly recommended that the entity needing to use
the MSG segment approach X12N with data maintenance to solve the
business need without the use of the MSG segment.

3. Benefit Disclaimers are strongly discouraged. See section 1.3.10
Disclaimers Within the Transaction. Under no circumstances are more
than one MSG segment to be used for a Benefit Disclaimer per
individual response.

-----Original Message-----
From: Murphy-Hole, Jan [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, July 02, 2002 4:24 PM
To: '[EMAIL PROTECTED]'
Cc: Rambaran, Sharmain; McCarter, Julie; DalPiaz, Laura; Douglass, Linda
Subject: The Use of Disclaimers in HIPAA


I have a general disclaimer definition question.  I've searched the WEDI
list serve and did not find the answer.

The 270/271 implementation guide states that disclaimers are strongly
discouraged and  we are forbidden to use the MSG segment when the
information can be codified. If we do use the MSG segment to issue a
disclaimer, we are limited to using it once per response.

Would a description of a benefit be considered a disclaimer?  We have a
benefit that cannot be coded so we may need to utilize the MSG segment to
further explain the benefit.  I am thinking of using the EB01 segment with
code 'D' Benefit Description, along with the explanation in  MSG01.  The
only other option I can find is to refer all inquiries to our customer
service reps and obviously, we do not want to do that.

Can the MSG segment be issued twice within the same response, once as a
'true' disclaimer and again as an explanation of a benefit?


Thank you,
Jan Murphy-Hole
Sr. Business Analyst
Great-West Life & Annuity
EBIS-HIPAA
10T3
303-737-3439
email: [EMAIL PROTECTED]





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