Unfortunately I did not see your message before the 834 workgroup met at X12 this week as this should have gone before them for opinion.
My personal opinion is that when we wrote this part of the implementation guide we wanted to give the flexibility to the trading partner to have an employer group identification in Table 1 and policy numbers in Table 2 at the member level OR at the health coverage level in order to accomodate different identifies. In the case when the group ID and policy number are one and the same, I would interpret this to mean that it gets sent in Table 1 and at the member level in Table 2. Paul Weber 916-449-6970 ----- Original Message ----- From: "O'Dell, Judy" <[EMAIL PROTECTED]> Date: Tue, 8 Oct 2002 16:44:59 -0400 To: "'[EMAIL PROTECTED]'" <[EMAIL PROTECTED]> Subject: 834 Transaction - Policy Number > 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. > > -- __________________________________________________________ Sign-up for your own FREE Personalized E-mail at Mail.com http://www.mail.com/?sr=signup "Free price comparison tool gives you the best prices and cash back!" http://www.bestbuyfinder.com/download.htm ********************************************************************** 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.
