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I have
been asked to add this information to lots of areas - all of which I am
extremely leery of implementing past 10/16/03.
One of the proposed "fixes" for this issue was to request of us to
send the TOS in a REF segment in the 2400 loop which the
payer has interpreted as "able to be used at their discretion" -
although the qualifier would really not apply to the information in the segment,
so I'm not sure that's a good idea.
It has also been requested of us to send this info as a
line note in the 2400 loop, but that concerns me because it would override any
possibility of a true line note.
Another request was asking us to send it in the line item
control number REF segment in the 2400 loop, but that's not an option either in
my opinion because payers are required to return this number in the remittance
advice transaction (835) if the providers sends it to them in the
837.
Most commonly, we are
being asked to send the TOS in SV106.
Is there really any way
for payers to be able to get around rewriting their adjudication
systems if they are currently dependent on type
of service?
Stacy M. Trease
EDI Programmer/Analyst, Gateway EDI Inc.
Co-Chair, MO SNIP TCS Subcommittee
(800) 969-3666 Ext 224
[EMAIL PROTECTED]
I am
just starting Medicaid programs by state for my company. Can you tell me what
Payers are requiring this information? And to what loops and segments
you are adding this information?
Any
help you could provide would be appreciated.
Tiffany Gutraj Rosik
Product Analyst
Amicore
Many
of our providers are running into the same thing, especially with the
Medicaid's. Because of edits in place today we had to add TOS to our ANSI
4010 format. I was not aware that this requirement might extend past
October.
We
are also finding that some payors are currently requiring in the 4010 the
responsible party's DOB and sex.
-----Original
Message-----
From: Stacy
Trease [mailto:[EMAIL PROTECTED]
Sent: Wednesday, March 19, 2003 2:42
PM
To: WEDI SNIP
Transactions Workgroup List
Subject: Type of Service still
needed?
Many
of the payers we have been testing with are informing us that they will
still need to receive the type of service code for claims after
10/16/2003. In the implementation guide, SV106 is marked as not used.
Is anyone else
running into this, and if so, how have you been handling it?
Thanks
for your input!
Stacy
M. Trease
EDI
Programmer/Analyst, Gateway EDI Inc.
Co-Chair,
MO SNIP TCS Subcommittee
(800)
969-3666 Ext 224
[EMAIL PROTECTED]
------------
Gateway EDI, Inc.
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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
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