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



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