No, a 277 sent in response to a phone or fax or other "manual" inquiry is
not a business process described in the 004010X093 implementation guide, so
it is not supported under that guide and is thus not mandated by HIPAA
(162.1402 - Standard for health care claim status). The only time a payer
is required to send a 277 under HIPAA is if the requestor sends a 276.
Of course a payer can opt to send a 277 in response to a manual request if
they choose to do so - but I've not heard of one who is willing to do that
- nor a provider wanting that.
Regards,
Laurance Stuntz
NEHEN Program Manager
Computer Sciences Corporation
office phone: 781.290.1479
fax: 781.890.1208
"Paul Costello"
<paul.costello@cg To: "WEDI SNIP Transactions
Workgroup List" <[EMAIL PROTECTED]>
i.com> cc: "WEDI SNIP Transactions
Workgroup List" <[EMAIL PROTECTED]>
Subject: Re: RE: 835
02/06/2003 12:28
PM
Please respond to
"Paul Costello"
So are you implying that whichever method is chosen to send an
eligibility benefit inquiry or a claim status inquiry is the same
method that must be used in the respective responses?
What is a provider calls a health plan inquiring about a claim, and for
whatever reason, wants the response via a 277 transaction - is this
acceptable?
Thanks,
Paul
----- Original Message -----
From: Marcallee Jackson <[EMAIL PROTECTED]>
Date: Thursday, February 6, 2003 5:50 am
Subject: RE: 835
> Hi Jim,
>
> The 837 and 835 are not paired transactions like the 270/271 or
> 276/277. A
> provider may conduct whichever HIPAA transaction it chooses with a
> payer and
> is not required (by HIPAA) to conduct electronic claims in order
> to receive
> an electronic ERA.
>
> Marcallee Jackson
> Director, Healthcare Solutions
> Edifecs, Inc.
> Office 562-438-6613
> Cell: 714-865-5059
>
> -----Original Message-----
> From: Burke, James [mailto:[EMAIL PROTECTED]]
> Sent: Thursday, February 06, 2003 5:37 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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