Please excuse this intrusion,
but I really want to know.
I run a rather large billing
center and monitor the list serves to keep current on EDI issues. I have
learned a great deal and understand the transactions just fine, but am missing a
piece of the puzzle when it comes to transactions aimed at physicians,
especially unsolicited transactions. Everybody knows where the insurance
companies are and how to get to them. How does a transaction get to a
physician if it is not a response transaction taking the same path as the
original transaction. Is their some master address file that says to get
to physician 12345 that you sent to clearinghouse abc ???? and if
you change clearinghouses, how does this get updated ???
Thinking in terms of a
physician wanting to send a 278 to refer a patient to another physician, how
would that transaction get routed and find its way to the other
physician.
Or if we require an HMO to
provide our physicians with monthly unsolicited 271 roster updates, how would
they get to us ???
I would be grateful if someone
could spare a moment to educate me.
Thanks
Pat
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