Hi,
We're finding in testing that the theory of Date of Service was fine, but
in reality ... people are switching systems over on particular dates so its
more likely that its based on a processing related date. Claims that are
in the Payer's "house" and in process on October 15th may have been
received using the 4010.
But if they are electronically reported on an 835 on October 16th, they
will be reported on an 4010A1 835 because that's the format in effect on
the day we'll run Financial.
We won't produce two formats of the same transaction, in the same Financial
run, for the same provider ... avoiding this nightmare was the whole
purpose for the urgency in making sure the Addenda got passed last month.
Hope it helps
Marsha
Verizon Information Technologies Inc.
Managed Care Division
Phoenix, AZ
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"Bard, Greg"
<[EMAIL PROTECTED] To: "WEDI SNIP Transactions
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cc:
03/20/2003 11:52 Subject: ADDENDA QUESTION
AM
Please respond to
"Bard, Greg"
I
If a 4010 837 is submitted prior to the compliance date that contains some
of the qualifiers that are being removed for the 4010A1, and the claim is
finalized AFTER the compliance date which causes the 835 to be built with
4010A1 compliance, how should these qualifiers be returned on the 835? If
the submitted qualifiers are returned, wouldn't a covered entity be out of
compliance? Can the covered entity assume that compliance is based on the
date of service?
Greg Bard
NASCO
HIPAA Privacy and Security Project Manager
(W) 678.441.6059
(F) 678.441.6359
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