I need help interpreting the IG for the 834 transaction. Below is excerpts from the IG regarding where policy number can be transmitted.
Header: Transaction Set Policy Number "1. This segment can be used if a unique ID Number for a group applies to the entire transaction set." Loop 2000: Member Policy Number "1. This segment should be used if the policy or group number applies to all coverage data (all 2300 loops) that apply for this member. 2. This segment is required unless the policy number is sent in the REF segment, loop 2300 position 290." Loop 2300: Health Coverage Policy Number "1. This segment should be used to identify a policy or group number for a particular insurance product if it has not already been identified in either REF02, position 1-030 or REF02, position 2-020. This is necessary when not all coverage types have the same group or policy number." The note under the Transaction Set Policy Number makes it look like the intent was if the policy number applies to the entire group, it can be submitted at this level and wouldn't be needed at either the Member or Health Coverage level. However, the note under the Member Policy Number states it's required if not sent at the Health Coverage Level. To me, this seems to defeat the purpose of having an option of sending it at the Transaction Set level. It looks like the IG is saying the only valid options are: Transaction Member Health Present Present Not Present Not Present Present Not Present Not Present Not Present Present There's no way to send it just at the Transaction Set level. How are other's handling this issue? Judy O'Dell EDS - Solutions Consulting 975 Eastwind Dr Suite 115 Westerville, OH 43081 phone: 01-614-823-4660 mailto:[EMAIL PROTECTED] www.eds.com ********************************************************************** 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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
