Cindy, I'm questioning the interpretation you noted. Yep, page 25 does have a little problem as there is a typo (indicates HL02=21 when it should be HL03=21); however, my interpretation of this paragraph is different. What I come away with is regardless of who the Information Receiver (requestor) is (service bureau, clearinghouse, or provider)the HL03 response for the Information Receiver will always be "21". Even when the Information Receiver also is the Service Provider. Additionally, when I look at the Information Receiver HL segment (Loop 2000B) the only valid response for Loop 2000B HL03 is "21" (page 61). I'm not quite sure how you could report "19" at Loop 2000B HL03 when it's not reflected as a valid response for that Loop segment combination. "19" is only listed as a valid response for the Service Provider level, Loop 2000C HL03 (page 66). Am I missing something?
Cindy Monarch, CPC MPHI HIPAA Business Analyst -----Original Message----- From: Cindy Gerber To: '[EMAIL PROTECTED]' Sent: 10/08/2002 3:21 PM Subject: RE: Information Receiver in 276 vs 270 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 ********************************************************************** 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/. 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