I should have clarified this in my first post - it might make it easier.

On page 25 of the implementation guide, v4010, The 3rd paragraph refers to
the value of HL03 for the info requester and service provider.  There
appears to be a typographical error as the last 2 sentences don't make
sense.  I asked about this at a local meeting we have to discuss
transactions (HCIM).  

We interpreted this to mean that if the requester is also the provider, HL03
should be valued with "19" at both the requester and provider levels.  If
the requester is not the servicing provider, the HL03 value for the info
requester would be "21", and the value for the service provider level would
be "19".

Hope this helps!

Cindy Gerber
MCare, Inc.

-----Original Message-----
From: Cindy Gerber [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, October 08, 2002 3:03 PM
To: '[EMAIL PROTECTED]'
Subject: RE: Information Receiver in 276 vs 270


My understanding is that the information receiver can be a clearinghouse,
provider, provider group, employer, etc.  If the information is requested
via a clearinghouse, on behalf of a provider, the response still goes back
to the requester (clearinghouse) who would then have to pass the information
back to the provider.

The information source is the payer.

Cindy Gerber
MCare, Inc.

-----Original Message-----
From: Sparma, Deborah, nashccon
[mailto:[EMAIL PROTECTED]]
Sent: Tuesday, October 08, 2002 2:38 PM
To: '[EMAIL PROTECTED]'
Subject: Information Receiver in 276 vs 270


Can anyone clarify the who the information receiver is in the 276. The 270
defines the Information Receiver as the entity who is asking the questions -
physician, hospital another insurer. So if the transaction is being sent
through a clearinghouse, I understand this to mean that the information
receiver is NOT the clearinghouse information.

I thought I could apply this same logic in the 276, however, the 276 defines
the information receiver as the entity who is expecting the response from
the information source - provider, employer or clearinghouse. Therefore, I
understand this to mean that if a provider sends the 276 transaction through
a clearinghouse, then the information receiver would actually be the
clearinghouse information, not the provider who is actually the one asking
the claim status request.

I would like to use the Information Receiver information in the 276 the same
way as in the 270, but I don't know if I can.

Does anyone else have a point of view?

Thanks,
Deborah Sparma


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