Group:
I read through the
Implementation Guide Selection white paper draft, dated
11/5/02. This paper
regarded the health care industry's
current billing methods, and explained how these affect which HIPAA
Implementation Guide may be used when billing for specific health care
services. We at Oxford are trying to determine whether to
build an 837D for Oral Surgery services.
The
survey included within the
paper illustrates what we have been discussing-that the dental provider
may either submit and 837P or 837D for an oral
surgical service. More to the point, there isn't any billing
consistency now and may not be in the
future.
From my point of view, the place of service (POS) and
provider should determine what transaction should be submitted. If the POS
is 21 and the facility is billing, and 837I should be used. If the Oral
Surgeon is billing, use and 837P. For regular dental services
(bitewing, prophylaxis, etc.) use an 837D. However, the survey suggests
perhaps using an 837P would be a more suitable format, since dental providers
use the proprietary 1500 format, so to speak.
Please let me know your thoughts as to the above.
Thank you for your consideration and
responses.
Regards,
Gary Tolin
Oxford Health
Plans
HIPAA Project
Manager
Internal:204-7301
External:
800-889-7658, x. 7301
e-mail:
[EMAIL PROTECTED]
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