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Marsha,
That's the way I read the regs. unvarnished 4010 ceases
to be an approved TX set at 00:00:01 on 16 Oct 2003. Of course,
you could start sending & receiving A1 now (it is also an approved TX set
from now until 15 Oct), and avoid the switchover problems, although leaving
customers out in the cold might not be well thought of. Better would be to
accept either, and send A1.
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
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----- Original Message -----
Sent: Thursday, March 20, 2003 02:05
PM
Subject: Re: ADDENDA QUESTION
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 Workgroup
List"
com>
<[EMAIL PROTECTED]>
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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