See 1.3.2.1 of the 276/277 Implementation Guide... Pre-Adjudication System Status Payers may pre-process claims to determine whether or not to introduce them to their adjudication system. This process is performed so that incorrectly formatted claims or those that are missing information can be returned to the provider for correction. Returned claims may not have claim numbers assigned by the payer. For additional information see the 277 Health Care Payer Unsolicited Claim Status Implementation Guide.
> -----Original Message----- > From: Matthew Fuller [SMTP:[EMAIL PROTECTED]] > Sent: Thursday, February 06, 2003 2:31 PM > To: WEDI SNIP Transactions Workgroup List > Subject: RE: RE: 835 > > I have a carrier who is using the 277 as an "acceptance" report to my > 837. Is that allowed? > > Thanks > Matthew Fuller > MMRI > > -----Original Message----- > From: Rachel Foerster [mailto:[EMAIL PROTECTED]] > Sent: Thursday, February 06, 2003 2:12 PM > To: WEDI SNIP Transactions Workgroup List > Subject: RE: RE: 835 > > > My opinion is that in order to receive a 277 response the provider must > first submit a 276 request. Furthermore, if the provider submits a 276 > request the payer is obligated to respond with a 277. Same goes for the > 270/271. > > Rachel Foerster > Principal > Rachel Foerster & Associates, Ltd. > Professionals in Health Care EDI > 39432 North Avenue > Beach Park, IL 60099 > Voice: 847-872-8070 > Fax: 847-872-6860 > eMail: [EMAIL PROTECTED] > http://www.rfa-edi.com > > > > -----Original Message----- > From: Paul Costello [mailto:[EMAIL PROTECTED]] > Sent: Thursday, February 06, 2003 11:28 AM > To: WEDI SNIP Transactions Workgroup List > Cc: WEDI SNIP Transactions Workgroup List > Subject: Re: RE: 835 > > > 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 > > > > > > --- > > The WEDI SNIP listserv to which you are subscribed is not moderated. > > The discussions on this listserv therefore represent the views of the > > individualparticipants, 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 > > personaldisagreements or unprofessional communication at any time. > > > > You are currently subscribed to wedi-transactions as: > > [EMAIL PROTECTED] 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/Unsubscribeform at http://subscribe.wedi.org > > > > > > --- > > 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] 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 > > > > > --- > 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 > > > --- > 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 > > --- > 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 --- 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
