Dave Sell asked:
> I'd like to know if any receivers will reject claims that have unneeded
> Situational segments or elements.
They certainly should. Two principle reasons:
a. the old chestnut of HIPAA compliance - sending unneeded situational
data would make a transaction non-compliant and both the sender and
receiver in breach of the rules (and so liable for fines if caught)
b. contractual and liability - if a receiver is not expecting certain
data items, then they won't have mapped it to anywhere in their
in-bound database or file format, which means that the data will
effectively get dropped. Their application is therefore unaware
that the unneeded data was sent and may accept, process, adjudicate
a claim on the basis of only the data it receives. Subsequently,
the claimant contests the adjudication on the basis of the unneeded
but silently dropped (thus looking like accepted) data which they
thought out to have been taken into consideration
Jonathan
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Jonathan Allen | [EMAIL PROTECTED] | Voice: 01404-823670
Barum Computer Consultants | | Fax: 01404-823671
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