Ruth: Providers may CHOOSE whether or not to receive an electronic EOMB, or paper. They have no mandate to do one or the other. Health plans must be able to send an electronic EOMB if requested. Since Medicare is going to mandate paying only electronic claims, I'm willing to bet most providers will want an electronic EOMB, because it's easier to deal with internally. They can then forward the EOMB themselves if there is no coordination of benefits with another health plan. Health plans will probably receive EOMBs with lots blanked out, due to Privacy and "minimum necessary", though. Does that help? Carolyn Price Perot Systems -----Original Message----- From: Thigpen, Ruth [mailto:[EMAIL PROTECTED]] Sent: Wednesday, May 29, 2002 9:59 AM To: '[EMAIL PROTECTED]' Subject: FW: MORE HIPAA 837 QUESTIONS
Would someone on this workgroup be able to answer my questions below or direct me to the correct individual/workgroup? Thanks for your help. Ruth Thigpen BCBS Florida 904-363-5973 [EMAIL PROTECTED] -----Original Message----- From: Pat Gooch [mailto:[EMAIL PROTECTED]] Sent: Friday, May 24, 2002 9:30 AM To: Thigpen, Ruth Subject: RE:MORE HIPAA 837 QUESTIONS Ruth, since your questions deal with what Medicare will be doing and the provider's processes after Medicare has paid, I would be unable to answer these questions with any degree of accuracy. My suggestion would be that you send your email out to the Business group on WEDI for your answers, or at least have someone point you in the direction where these questions might be already answered and documented. Their email is [EMAIL PROTECTED] . Hope this helps. Pat ------------------( Forwarded letter 1 follows )--------------------- Date: Thu, 23 May 2002 17:46:24 -0400 To: pat.gooch Cc: [EMAIL PROTECTED] From: [EMAIL PROTECTED] Subject: MORE HIPAA 837 QUESTIONS Pat, I have several more questions pertaining to COB information coming in on the 837 (applies to both the Institutional and Professional ) and the 835 transactions. We are trying to finalize our 837 crosswalks and business rules and need a response just as soon as possible. Would you be able to help me get the answers to the following or is there someone else on the workgroup that I can contact? * Will providers choose whether or not to receive electronic 835's or paper remittances/EOMBs from CMS (Medicare carrier/intermediary) after HIPAA or is there a mandate that applies to Medicare regarding the electronic 835? * If a plan does not have the Payer-to-Payer COB model, a provider can use the primary payer's information from an electronic 835 or paper remittance/EOB to generate an 837 transaction to the secondary/tertiary Blue Cross Blue Shield of Florida, Inc., and its subsidiary and affiliate companies are not responsible for errors or omissions in this e-mail message. Any personal comments made in this e-mail do not reflect the views of Blue Cross Blue Shield of Florida, Inc. To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address. 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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address. 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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
