First of all, why didn't you use the 276/277 listserv?   Also, you might
attend the 276/277 phone conference meetings on every other Thursday at 1
pm ET.
Secondly, if you also use the member id sent on the 276, that in
combination with the provider id should get you the limited claims that
would satisfy the privacy issue you raise.




"Hal Scoggins" <[EMAIL PROTECTED]> on 04/09/2002 12:20:03 PM

To:    <[EMAIL PROTECTED]>, <[EMAIL PROTECTED]>
cc:
Subject:    More 276/277 questions - they just keep surfacing





Folks,

Now that we're  wading deeper into the 276/277, more questions are
surfacing. Hopefully, someone  monitoring this listserv can help�us
address�them.

I'll post more as I  remember them, but the immediate question we have is
regarding the information  we send back to the originator of the 276
inquiry.

There is a large  possibility that we will be unable to precisely identify
the Provider specified  in the 276, since all we have to go on is a name
and TIN. This being the case,  it is possible that we may find multiple
claims that match the information  given. When this happens, the 276/277 IG
indicates that we should return the  status of all claims we find that
match the inquiry. But this raises questions  about privacy. Our impression
is that the IGs are written strictly from a  technical perspective, with
no�consideration of security and privacy  concerns. If we send back status
info about all matching claims, without being  sure of precisely who the
Provider is in the inquiry, are we going to be  violating some other piece
of HIPAA?

On a related  note; in the NM1 segment for the Service Provider, NM108
offers an "SV"  qualifier, with the note, "When the provider does not have
a National Provider  ID and Payer has assigned a specific ID number to this
provider this code is  required." We have assigned such an ID number to
each provider in our system.  While this would help us "nail down" the
provider, one of our claims processing trainers asserts that�it is
unreasonable to expect a provider to  keep track of every unique ID number
assigned to them by each of the potentially  hundreds of insurance plans
they deal with. While the IG appears to give us  carte blanche�- perhaps
even demands, if one gets right down to it  -�to reject any 276 that comes
in without that ID included, folks in our  office with significant
experience assure us that our assigned ID simply won't  show up on the 276.
So where does that leave us?�If we accept the 276 without that ID,  since
we have, indeed, assigned it, then we are accepting a non-compliant
transaction, since the note says that it is "required." But it seems that
we  will be rejecting 100% of the inquiries we receive, if we stubbornly
insist on  adhering strictly to the rules.

Any thoughts on either of these  issues?

Hal  Scoggins
SBPA Systems, Inc.
(281) 679-7272  x116

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