Gary,
Where can we get a copy of the Implementation Guide Selection white paper
draft?
Kelly R.Davis
Nationwide Health Plans
HIPAA Project Coordinator
[EMAIL PROTECTED]
"Tolin, Gary T."
<[EMAIL PROTECTED]> T
To: "WEDI SNIP Transactions
Workgroup List"
<[EMAIL PROTECTED]>
cc:
11/11/02 04:31 PM bcc:
Please respond to "WEDI Subject:
Medical Dental Claims and IG
SNIP Transactions selection
Workgroup List"
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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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
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