Brain,
You might ask this question at a CMS conference call this Friday.

The Centers for Medicare & Medicaid Services (CMS) is pleased to invite
you to participate in our fifth HIPAA Implementation Roundtable
conference call. 

Day/Date/Time:
Friday, October 25, 2002 from 2:00 - 3:30 PM EST

Location:   (Conference Call Only)

The call in number is 1-877-381-6315. The conference identification
number is 6116768.  

Regards,

David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
www.gefeg.com
425-260-5030

-----Original Message-----
From: Young, Brian [mailto:BYOUNG@;accu-med.com] 
Sent: Tuesday, October 22, 2002 7:43 AM
To: '[EMAIL PROTECTED]'
Subject: 837 I - SBR03/SBR04 Policy Number & Group Name 

Morning all,

Question from an 837I tester... I have been testing with a few of CMS's
FIs
and have been getting different information with each test.  Granted I
am
using data from providers that the FI would serve; but, are we still
hitting
a moving target?  I am getting conflicting information about when to use
what elements.  And these testing environments one would expect to be
the
same.  They are all CMS FIs.


Case in point:

I have tested with UGS and AdminaStar. Both tests have cleared front end
edits  and have received approval from AdminaStar for the transmission
elements described above.  In these 2 elements I do not supply any data
as
they are optional fields.  I supply the Medicare policy number in the
NM109
field as described in the SBR03 notes.  

The kicker on the latest testing, the intermediary says that one of
these 2
fields is required.  They are indicating that if SBR03 is empty then
SBR04
must be filled.  The question I have is, is this true?  I read the notes
from SBR04 and it reads "Used only when no group number is reported in
SBR03."  Now I'm not sure about their interpretation of English, but I
dont
see the words "must be used if" in that sentence.  Am I wrong?  How do I
push back on this?

Like I said... I feel like I have been trying to hit a moving target.
And
if the target is moving... then my program must move too.  Now do I go
back
and retest?  Granted its only one now... but later it could be dozens.

Please excuse the small rant... but could use some help.

Thx,

     BCY

Brian C. Young
Accu-Med Services Inc.
An OmniCare Company
Milford, OH 45150
513.831.1207

  


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