From: Rick Maere <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Subject: 837D question
List Serve Participants:
The State of Illinois uses a fiscal intermediary to help administer the dental
program. The State contracts with a third party entity to handle enrolling the dental
providers, providing dental access to participants, approving/disapproving the prior
authorizations, adjudicating the claims and submitting the claims to the Department
for processing.
Issue: The contract administrator receives the claim and must comply with the Federal
mandates of paying 90% of the claims within 30 days of receipt and 99% within 90 days.
This adjudication must be monitored. However, the HIPAA 837D does not recognize a
"Date Received" section for submission of this information.
Does any other state have this problem? If so, how have you resolved it within the
X12 837 guidelines?
Thanks!
Rick Maere
IL Dept of Public Aid
557-9783
[EMAIL PROTECTED]
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