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Gary, You are
correct that the topic of which form to use is a guess in some situations. There are other factors to consider as
well. Here are
some other factors to consider when deciding which transaction to build for
Oral Surgery services.
I would
respectfully disagree with the comment that “since dental providers use the proprietary 1500 format, so to
speak.” It has been my experience
that few dental offices (outside of the hospital setting) use any format other
than the 837D. Inside of the
hospital, there is a strong case to use the 837P, since the systems in place
can handle (or will be able to handle) that format already. Interesting
topic. Tom
Drinkard EDIT, Inc. (678)
795-1251 -----Original
Message----- 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] --- 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-transactions 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 |
- Medical Dental Claims and IG selection Tolin, Gary T.
- Re: Medical Dental Claims and IG selection DAVISK30
- Tom Drinkard
