Re: 277 RESPONSE TO CLAIMS SUBMITED BEFORE 10/16/2003

[Doug Webb]

Alex, Basically, you need to respond to any 276 query. The response may be "Not Found".  You should, however, respond with the status of any claim that is in your adjudication system, independant of the date processed, or what format it was received in.   On Page 11 of the IG, some parameters on length of availability are laid out -- For realtime access, claims accepted into the adjudication system in the last 90 days are to be reported on; for batch access, and claim that has not been purged from the adjudication system is to be reported on.  The combination of the two modes of access implies that the claim status must be available in the adjudication system for a minimum of 90 days from the time it was accepted into the adjudication system.   If complient claims are in a separate adjudication system from the legacy claims, it has been argued that the legacy claims could be classified as "purged", and thus not available for 276 query.  I think that this is a poor approach.  A better one would be to load into the new system a record indicating that a claim exists (subscriber / patient / date / provider info, no service info or other status), and to return a status of "No further status is available electronically"   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 [EMAIL PROTECTED]   "This electronic message may contain information that is confidential and/or legally privileged. It is intended only for the use of the individual(s) and entity(s)  named as recipients in the message. If you are not an intended recipient of the message, please notify the sender immediately,  delete the material from any computer, do not deliver, distribute, or copy this message, and do not disclose its contents or take action in reliance on the information it contains. Thank you."     ----- Original Message ----- From: Alex Kaplun To: WEDI SNIP Transactions Workgroup List Sent: Tuesday, September 23, 2003 01:02 PM Subject: 277 RESPONSE TO CLAIMS SUBMITED BEFORE 10/16/2003 Hello All, Are we required to generate a 277  -claim response to claims received prior to 10/16/2003? can you please point me to some legal paper on this issue Thanks Alex --- 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 --- 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