Walt, I think we just talked past each other. If you had commented in-line, then my text would have appeared next to yours and we would have seen that we are saying the same thing.
> You conveniently dropped my comments on Uniform Billing in order to make my > comments support your arguments. I didn't intend to create that effect. I agree that Uniform Billing is not a financially viable option at this stage. JA> As you describe it, any receiving payer has to accept a variety of data JA> that they do not want in order to pass it on down the chain. But their JA> input database or file layout must have space allocated for that data so JA> that it can be replayed later - so it cannot get silently dropped on the JA> floor. In other words, the payer has taken a conscious business decision JA> to examine, store and ignore-for-themselves the data that they don't need JA> so that they can regurgitate it for a secondary/tertiary payer. Any data JA> that shouldn't be in the input stream (at all) will cause rejection. So JA> no-one should get sued for not seeing/processing any data. WT> Since payers can not reject transactions because of the existence of data WT> they do not need to adjudicate the claim, and since payers are required to WT> pass the claim on to other payers without changing anything on the claim WT> other than the elements they are supposed to change, is there any reason why WT> providers can not include situational data elements regardless of the need WT> of the payers in the chain of a single claim? If we accept this premise, WT> then providers aught to be able to minimize changes to elements sent for WT> individual service codes by starting with a set of elements that are WT> required by any of their payers and bill those elements all the time. Those two paragraphs seem to match content fairly well to me although written from different points of persepctive. Providers send data that each individual payer may not need so that it can be passed on to others; payers have agreed to store and hold data that they don't need to pass it on to others thus keeping the system going. The only area of concern is that payers have to take a conscious decision to support the through-passage of data that they themselves don't actually require in their own business model. If they are not aware that this decision needs to considered and taken, then data can get lost/dropped and providers may have to bill separately. I had taken Dave's original question to be talking about the transmission of situational data for which the situation didn't apply. Are we together now ? Jonathan ------------------------------------------------------------------------------ Jonathan Allen | [EMAIL PROTECTED] | Voice: 01404-823670 Barum Computer Consultants | | Fax: 01404-823671 ------------------------------------------------------------------------------ --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. 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 products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
