The only typo is HL02=21.  It should have said HL03=21.  In that example
what they are saying is that when the servicing provider is the trading
partner then the provider is both the information receiver at level 21 and
the provider at level 19.  

Sending two 19's as you propose results in a non-compliance error.  First
off your provider level HL's won't have a receiver level to point to in the
HL02. Both would have to point to the source level or one to the other
provider and that one to the source.  Either way the mandated structure is
hosed. 



-----Original Message-----
From: Cindy Gerber
To: '[EMAIL PROTECTED]'
Sent: 10/8/02 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


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