The provider can send a request to the payer for any type of combination of
claims submission and remittance/pymt receipt.  The rule says that the payer
cannot refuse to send/receive a transaction as requested by the provider.  

Scenarios as discussed btwn provider/payer:
1.  The provider can send paper claim and receive paper remittance  
2.  The provider can send paper claim and ask to receive an 835 -- the payer
now has the "right" to ask the provider to send the appropriate information
necessary to populate a compliate 835 if that information is not on the
paper claim because the provider cannot ask the payer to send a
"non-compliant" 835.
3.  The provider can send a 837 and receive paper remittance.
4.  The provider can send a 837 and receive and 835.

hope this helps.

Ruth Tucci-Kaufhold 
HIPAA Systems Analyst 

Co-Founder MAHI 
UNISYS Corporation 
4050 Innslake Drive 
Suite 202 
Glen Allen, VA  23060 
(804) 346-1138 
(804) 935-1647 (fax) 
N246-1138 
[EMAIL PROTECTED] 



-----Original Message-----
From: Burke, James [mailto:[EMAIL PROTECTED]]
Sent: Thursday, February 06, 2003 8:37 AM
To: WEDI SNIP Transactions Workgroup List
Subject: 835


If a provider sends claims as paper to a payer, can the provider request an
835? Does a provider have to send an 837 to get an 835 back?

Jim Burke
EDI Programmer Analyst 
Healthlink 
12443 Olive Boulevard
St. Louis, MO 63141
(314)-989-6413 Phone
(314)989-6643  Fax

~*~ So long for just awhile ~*~
                                         -Jack Buck


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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 
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Database at http://snip.wedi.org/tracking/.   These listservs should not be used for 
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They also are not intended to be used as a forum for personal disagreements or 
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