Joanne You've made a good point (things are confusing enough without mis-information!). I hope you don't mind if I forward your question to the list serves as other people are probably also confused. My apologies. Let me try again.
When the original submitter of the claim (presumably a provider or their rep) creates an 837, it might have in it COB information listing other possible payers. This qualifies it as a COB claim. However, at the first submission there isn't any payment information in it (nobody has paid on the claim yet). When the provider gets the payment information back from the first payer, they then have the opportunity to create what I think of (and this isn't really quite correct now that I think about it) as a 'real' COB claim - a claim that incorporates actual payment information in it. (Of course a 'real' COB claim doesn't have to incorporate payment information so my statement in the first email was incorrect.) This would be the only time when bunding and unbundling information would be included in the claim since the only source of that information is the 835. Does that make sense? Jan [EMAIL PROTECTED] wrote: > Jan, > You wrote this in an email to someone and we alittle confused by the statement " > Bundling and unbundling only impact COB claims; i.e.," Incoming 837 get bundled > and unbundled. Were you saying it does not impact the submitter of the claim > since they would create the 837 as they usually do and the payer does the > Bundling and unbundling? Thanks for the clarification...jo > > Durga, > Yes, although payers are required to use national code sets, payers are > allowed to continue their current adjudication processes. Hence, payers > may bundle or unbundle service lines to meet their business/contractual > needs. > > Bundling and unbundling only impact COB claims; i.e., those claims which > contain payment information (information that came in on the 835). The > job of the entity creating the COB claim is to correctly crosswalk the > payment information (including any bundling/unbundling) from the 835 to > the 837. Does that answer your question? > > Jan Root > > [EMAIL PROTECTED] wrote: > > "Empire Blue Cross Blue Shield" made the following > annotations on 07/11/02 07:39:51 > ------------------------------------------------------------------------------ > > [INFO] -- Access Manager: > Attention! This electronic message contains information that may be legally >confidential and/or privileged. The information is intended solely for the >individual or entity named above and access by anyone else is unauthorized. If you >are not the intended recipient, any disclosure, copying, distribution, or use of the >contents of this information is prohibited and may be unlawful. If you have received >this electronic transmission in error, please reply immediately to the sender that >you have received the message in error, and delete it. ********************************************************************** 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.
