I am working on the payer/external reviewer side of the 278. The IG indicates that it is mostly an echo. Situational segments, if sent, should be assumed to serve an important purpose. The differences I can see between the request and response are:
1. The UMO and Requester loops should contain detailed information identifying the sender (the UMO loop should have _extra_ segments in a response, and the response should remove the situational segments of requester loop). 2. The AAA and HCR segments are added. 3. Only if a service loop is accepted/certified with modifications, should the service loop be significantly changed. Any services or service details that are authorized should be present in the response. Basically, a small requester, should be able to tell what happened, what services are authorized/certified from the response alone. If a payer returns a response that does not have "modified" in the action and yet service loop segments from the original request are missing, then the meaning of the response is ambiguous. Oran Switzer Systems Analyst HSAG Martin Scholl wrote: I working on the provider side of the 278 right now. Is the 278 response an echo of the request with additional segments AAA or HCR, or is it conceivable that a payer returns only the bare minimum information, leaving out situational elements that came in on the request? Those of us on the payer side: How are you handling the 278? Martin Scholl [EMAIL PROTECTED] www.HIPAASuite.com 301-924-5537 Voice 301-570-0139 Fax ********************************************************************** 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.
