Jan -
I am not very familiar with this transaction. I am curious to know how (or if) this integrates with your development of the 276/277 pair required by HIPAA. Are you using this instead of trying to implement the 276/277 pair? Have any of your providers expressed interest in the 276/277 or does this seem to fit their needs?
Also, it is my understanding that most commercial translators can automatically return a 997 as Front-End Acknowledgement (no development needed). But it sounds as if the 277 is produced by doing some pre-processing edits on the claim data - after any translation steps have been completed. Is this correct? What level of information do you use the 277 to provide?
Thank you,
Ellen Tatge
-----Original Message-----
From: Jan Root [mailto:[EMAIL PROTECTED]]
Sent: Thursday, February 06, 2003 1:31 PM
To: WEDI SNIP Transactions Workgroup List
Subject: Re: 835
The Claim Acknowledgement/Acceptance report/Error report (it has many names) is not a HIPAA transaction. Therefore, payers may use whatever they wish to electronically acknowledge a claim (which, as any provider who has sent claims through multiple clearinghouses knows, is a real pain!). I think there is a movement affot to include the 277 Front-end Acknowledgement (as we call it here) in the next round of required HIPAA transactions. It's a nifty transaction if I do say so myself! (good job Work Group!) We're beginning to use it here in Utah and the providers love it. The Utah Insurance Department has adopted it as the Utah
State Standard for the claim acknowledgement transaction.
Jan Root
UHIN
Matthew Fuller wrote:
> 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
> >
> >
> > ---
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