My turn to chime in - my strong recollection is that type 7 applies to only those payer-specific edits that are in the HIPAA implementation guides - Medicare, Medicaid, and Indian Health (although, by the way, I haven't noticed any references in the IGs to Indian Health...that's probably because I just missed them...)
Other payer-specific edits, allowable only where explicitly provided for per the language of the IG (e.g. situational elements in the 837s that are to be included when needed for claims adjudication) would be business-to-business edits... Cynthia ----- Original Message ----- From: <[EMAIL PROTECTED]> To: "WEDI SNIP Testing Subworkgroup List" <[EMAIL PROTECTED]> Sent: Thursday, November 14, 2002 2:19 PM Subject: RE: RE: Payer Edits > > Mark is right. To the best of my recollection, when levels were changed to types, type 7 is added to capture all payer specific edits. > > Even though at that time, it was said, the special payers for type 7 are agencies like medicaid, Indian medicine etc., Don't know if that covers all payer specific edits or if we need new type 8 as John alluded in his reply. > > Regards, --Rama. > > -----Original Message----- > From: "McLaughlin, Mark (DBQ)" <[EMAIL PROTECTED]> > Sent: Thu, 14 Nov 2002 13:28:23 -0500 > To: "WEDI SNIP Testing Subworkgroup List" <[EMAIL PROTECTED]> > Subject: RE: Payer Edits > > Patrice, I doubt that they will become Type 8. In the testing white > paper it mentions that Type 7 payer specific editing is related to IG > specific business rules. It also states that other payer specific > business rules not tied to the IG's are handled through the business to > business testing between trading partners. That would mean that this > type of testing is addressed in the other white paper on this subject > called Business to Business Testing. > > > Mark > > > > Mark McLaughlin > > Regulatory Policy Analyst > > McKesson > > 700 Locust St. Suite 500 > > Mail stop IADU-7 > > Dubuque, IA 52001 > > (563) 557-3654 phone > > (563) 557-3334 fax > > [EMAIL PROTECTED] > > Confidentiality Notice: This e-mail message, including any > attachments, is for the sole use of the intended recipient(s) and may > contain confidential and privileged information. Any unauthorized > review, use, disclosure or distribution is prohibited. If you are not > the intended recipient, please contact the sender by reply e-mail and > destroy all copies of the original message. > > > > > > -----Original Message----- > From: Thaler, Patrice M [ mailto:Patrice.Thaler@;allina.com > <mailto:Patrice.Thaler@;allina.com> ] > Sent: Thursday, November 14, 2002 12:00 PM > To: WEDI SNIP Testing Subworkgroup List > Subject: RE: Payer Edits > > > Do you think you will refer to them as type 8? > This is for a communication piece or MN HIPAA Collaborative is working > on. > Thank you > > -----Original Message----- > From: [EMAIL PROTECTED] [ mailto:john.lilleston@;verizon.com > <mailto:john.lilleston@;verizon.com> ] > Sent: Thursday, November 14, 2002 11:31 AM > To: WEDI SNIP Testing Subworkgroup List > Subject: Re: Payer Edits > > > > Patrice, > > Yes...any payer edits that are not mentioned in the X12N implementation > guides would be referred to as the next type of testing. Our plans are > to > delve more into that subject in the Business to Business Testing white > paper. > > _______________________________________________ > > John Lilleston > Technical Supervisor > Verizon Information Technologies, Inc. > Healthcare Solutions > 813-979-3225 > [EMAIL PROTECTED] > http://www.VerizonIT.com/ <http://www.VerizonIT.com/> > _______________________________________________ > > > > > "Thaler, Patrice > > M" To: "WEDI SNIP > Testing Subworkgroup List" > <Patrice.Thaler@a > <[EMAIL PROTECTED]> > llina.com> cc: > > Subject: Payer Edits > > 11/14/2002 12:26 > > PM > > Please respond to > > "WEDI SNIP > > Testing > > Subworkgroup > > List" > > > > > > > > > > There are some payers that are developing their own companion guides and > we > will be testing against them with a tool prior to direct testing. Would > we > call this "Type 8" testing? > > > Patrice Thaler > Allina Hospitals and Clinics > HIPAA Project Manager > Phone: 612-775-9705 > Pager: 612-654-3066 > Fax: 612-775-9715 > > > > --- > 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/ <http://snip.wedi.org/tracking/> . These > listservs should not be used for > commercial marketing purposes or discussion of specific vendor products > and > services. They also are not intended to be used as a forum for personal > disagreements or unprofessional communication at any time. > > You are currently subscribed to wedi-testing as: > [EMAIL PROTECTED] > To unsubscribe from this list, go to the Subscribe/Unsubscribe form at > http://subscribe.wedi.org <http://subscribe.wedi.org> or send a blank > email to > [EMAIL PROTECTED] > If you need to unsubscribe but your current email address is not the > same > as the address subscribed to the list, please use the > Subscribe/Unsubscribe > form at http://subscribe.wedi.org <http://subscribe.wedi.org> > > > > > > > --- > 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/ <http://snip.wedi.org/tracking/> . > These listservs should not be used for commercial marketing purposes or > discussion of specific vendor products and services. They also are not > intended to be used as a forum for personal disagreements or > unprofessional communication at any time. > > You are currently subscribed to wedi-testing as: > [EMAIL PROTECTED] > To unsubscribe from this list, go to the Subscribe/Unsubscribe form at > http://subscribe.wedi.org <http://subscribe.wedi.org> or send a blank > email to [EMAIL PROTECTED] > > If you need to unsubscribe but your current email address is not the > same as the address subscribed to the list, please use the > Subscribe/Unsubscribe form at http://subscribe.wedi.org > <http://subscribe.wedi.org> > > --- > 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/ <http://snip.wedi.org/tracking/> . > These listservs should not be used for commercial marketing purposes or > discussion of specific vendor products and services. They also are not > intended to be used as a forum for personal disagreements or > unprofessional communication at any time. > > You are currently subscribed to wedi-testing as: > [EMAIL PROTECTED] > To unsubscribe from this list, go to the Subscribe/Unsubscribe form at > http://subscribe.wedi.org <http://subscribe.wedi.org> or send a blank > email to [EMAIL PROTECTED] > > If you need to unsubscribe but your current email address is not the > same as the address subscribed to the list, please use the > Subscribe/Unsubscribe form at http://subscribe.wedi.org > <http://subscribe.wedi.org> > > > > --- > 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/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. > > You are currently subscribed to wedi-testing as: [EMAIL PROTECTED] > To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] > If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org > > > > --- > 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/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. > > You are currently subscribed to wedi-testing as: [EMAIL PROTECTED] > To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] > If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- 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/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-testing as: [email protected] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
