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Susan,
By the time one of those 'For Dummies" books is written, the
regs will change, even at eht glacial rate the government does things.
Unfortunately, I don't think that the thing can be simplified.
With the huge numbers of Situational values in the 837 (and
others), only the person who is fully familiar with the situation can make the
decision whether the situation applies. When in doubt, err on the side of
sending unneeded information, since extra info just wastes bandwidth, while
leaving out something the payor needs results in non-payment.
The opinions expressed here are my own and not necessarily the opinion of
LCMH.
Douglas M. Webb Computer System Engineer Little Company of Mary
Hospital & Health Care Centers [EMAIL PROTECTED]
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----- Original Message -----
Sent: Thursday, March 06, 2003 05:30
PM
Subject: RE: Gap Analysis for 837P vs
HCFA 1500/NSF
Brenda,
I was not able to find a 'crosswalk in a box'
that really met my needs as a
provider. However both my software vendor
and
my clearinghouse helped me in my gap analysis. Each of them produced a
gap
analysis of the data elements that they needed to add to their products
(or
that I needed to add to my file) to create a 'complete'
transaction. I also
used some of the other 1500-837 type crosswalks
that were available to
augment my gap analysis, however when push came to
shove I still had to
review the Professional Implementation Guide (IG) to
make sure I got
everything I needed. As a provider it is my responsibility
to be compliant
not my software vendor, so to cover all the basis, I did a
complete review
of the Implementation Guide. I came up with discrepancies
between what I
thought I would need and what my vendors thought I would
need so there
really is no substitute for going through the IG.
Susan
-----Original Message-----
From: Brenda K. Burton
[mailto:[EMAIL PROTECTED]
Sent: Thursday, March 06, 2003 3:03
PM
To: WEDI SNIP Transactions Workgroup List
Subject: Gap Analysis for
837P vs HCFA 1500/NSF
Can someone point me in the right
direction... we are a billing company and
looking to find a concise,
easy to understand list or gap analysis to help
us understand what data
elements are needed in addition to what we already
collect to submit a
claim.
I already looked at the WPC-EDI guide and it's a bit too techy
for me. I
reviewed the Proxymed HCFA 1500-837P crosswalk and found
that helpful, yet
still not thorough enough for my needs.
So, where
can I find a, excuse the term, 'dumb-it-down' version explaining
this
information? For example, I understand that the "Type of
Service
(TOS)" code will no longer be necessary. What will replace
this if anything
(a taxonomy code)?
Feel free to E me off the list
as well. Thanks in advance for your help!
Best,
Brenda
Brenda K. Burton
MEDEXTEND
877-491-7650
Available on
Instant Messenger as: medextend
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