The note on the 2000A (Billing Provider HL) seems to be irrelevant (and
possibly a "typo") since Billing Providers don't have claims - only
Patients and Subscribers do.
Also see that the same note appears on the 2000C Patient or Dependent HL
where it's just as seemingly useless; all Patient HL loops contain
claims and HL04 is always 0 (i.e., no subsequent enveloped HLs are
contained in the Patient loop). The note really only makes sense in the
context of the Subscriber, which has an altogether - and more helpful -
explanation of why HL04 would vary.
William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320
----- Original Message -----
From: "Kepa Zubeldia" <[EMAIL PROTECTED]>
To: "WEDI SNIP Transactions Workgroup List"
<[EMAIL PROTECTED]>
Sent: Friday, 07 March, 2003 06:29 PM
Subject: Re: Provider Hierarchical Question
Nina,
That is correct. The 2000A and 2000B are "parent-child" loops. This
means that the 2000B is a "child" of the 2000A loop. And, if there is a
2000C present, the 2000C will be a child of the 2000B loop.
The implementation guide shows these loops apparently at the same level
in page 47, but in reality, they are nested within each other.
For example:
1000A Submitter
1000B Receiver
2000A Billing Provider
2000B Subscriber
2000B Subscriber
2000B Subscriber
2000C Patient
2000B Subscriber
2000C Patient
2000C Patient
2000B Subscriber
2000A Another Billing Provider
2000B Subscriber
2000C Patient
2000B Subscriber
2000C Patient
2000A Another Billing Provider
...
and so on.
The HL structure defines these nested loops, even though when you see
them with the X12 glasses there is not the graphical nesting that I just
depicted.
I hope this helps.
Kepa Zubeldia
Claredi
----- Original Message -----
From: "McClure, Nina" <[EMAIL PROTECTED]>
To: "WEDI SNIP Transactions Workgroup List"
<[EMAIL PROTECTED]>
Sent: Friday, 07 March, 2003 04:08 PM
Subject: Provider Hierarchical Question
The following element in the 837I Implementation Guide has me rather
confused:
Loop 2000A
Segment HL
Element HL04 - Hierarchical Child Code
The I.G. states:
The claim loop (Loop ID-2300) can be used only when HL04
has no subordinate levels (HL04 = 0).
(This notation is not present in the 837P I.G.)
The only code option designated for the Element is:
1 Additional Subordinate HL Data Segment in This
Hierarchical Structure.
Is this a typo in the 837I I.G.? It seems to suggest that 0 is not a
valid value and therefore the 2300 loop cannot be used, but that doesn't
make any sense...
Any assistance in deciphering this would be greatly appreciated!
Nina McClure
Nina J. McClure
IT Compliance Analyst
Gambro Healthcare
[EMAIL PROTECTED]
(303) 542-5385
---
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