All:
Issue-a health plan has a risk
relationship with a vendor who processes specialty claims. That vendor has
liability for certain procedure codes on a claim. The health plan has the
responsibility for processing all other codes on the claim. Consequently,
the claim is "split".
Question-after the vendor and plan process
the services for which each is liable, to whom does the responsibility fall to
send a 277 should the provider request a status on a split claim?
Addtionally, who is responsible for sending an 835 should it be
requested?
Any thoughts would be
greatly appreciated. Please provide specific links to any answers
provided, as I would like precise documentation.
Thanks in advance for your
assistance!
Regards,
Gary Tolin
Oxford Health
Plans
HIPAA Project
Manager
Internal:204-7301
External:
800-889-7658, x. 7301
e-mail: [EMAIL PROTECTED]
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