Clyde
-
To points of reference I can think of:
Pg. 18 & 19 of the front matter of the 276/277 IG explains the
Claim Status Theory and the minimum requirements for the
transaction.
Also,
on page 28 under 2.2.3.2 Claim it states "In some payers' adjudication systems,
a request for claim line item status can be accommodated." This implies some
payers adjudication systems cannot.
If a
payer can only support claim level requests, then it should be clearly indicated
in the Trading Partner Agreement as such.
Deborah Sparma
Datatek Consulting Group
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Monday, September 23, 2002 9:51 AM
To: [EMAIL PROTECTED]
Subject: Permitted Responses to 276 Inquiries
All -
A major payer in out state has made a business decision to respond to 276 inquiries only at the claim level. This means that if they get a 276 inquiry for a specific service line, they will only respond with information about the adjudication status of the entire claim that included that service line. Is this approach permitted under the 276/277 IG or can anyone point me to relevent sections of the IG to answer this issue?
Thanks
Clyde A. Hanks, COO
The Health Care Interchange of Michigan
(860) 674-8911
(860) 674-8901 fax
(248) 789-7634 cell
[EMAIL PROTECTED]
www.HCIM.org
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