Thanks Dave. I'll check it out. Deborah
-----Original Message----- From: David A. Feinberg, C.D.P. [mailto:[EMAIL PROTECTED]] Sent: Thursday, September 19, 2002 6:27 PM To: [EMAIL PROTECTED] Subject: Re: Capitation payments and the 835 and 271 Deborah, X12N has, as one example, an Eligibility Roster Implementation Guide, number X040, based solely on the 271 Transaction Set, that describes an unsolicited message. It's available at www.wpc-edi.com for voluntary use -- as are numerous other X12N Implementation Guides that have not been adopted [yet?] for HIPAA. It's a bigger world out there than we often imagine. Enjoy. Dave Feinberg Rensis Corporation [A Consulting Company] 206-617-1717 [EMAIL PROTECTED] ----- Original Message ----- From: "Sparma, Deborah, nashccon" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, September 19, 2002 10:00 AM Subject: Capitation payments and the 835 and 271 I am trying to figure out the intended use of the wording in the 835 IG front matter where it says the following: "The 835 is used to provide financial notification of capitation payments from a Managed Care Organization (MCO) to a capitated care provider. The 835 does not contain the capitation details or membership roster. Use an associated Eligibility and Benefits Notification Transaction Set (271) to communicate these details. Capitation payments may be included with claims payment information in a single 835 or they may be passed alone. In either case, the existing balancing process for the 835 applies." Is this implying that a 270 has to be sent for every occurrence at the member level since there is no 271 unsolicited? Has anyone considered using this process? If so, how? Thanks, Deborah Sparma Datateck Consulting Group [EMAIL PROTECTED] (303) 534-0109 ********************************************************************** 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.
