I doubt the "Secretary" intended anything; do you think the Hons.
Shalala and Thompson actually ever read this stuff?  The Secretary is an
important C-Level guy, and just has his minions tell him what to sign.

Anyway, as I said before,  I think it would be completely permissible
for the payer to accept all but the one non-compliant claim - and as a
matter of fact, that may well be the technically advantageous way of
handling the situation most of the time.

Most any kind of X12 syntax error will be automatically detected by the
translator, which will issue a negative 997;  there may not be any way
around this depending on the translator product.  Obviously, missing
mandatory segments make it awfully hard to navigate the transaction set,
and makes it Dead On Arrival. There are some less serious X12 syntax
errors, like trailing blanks in alphanumeric fields: should the
translator completely fail the transaction set in this case? But
considering X12 syntax is completely deterministic, negative 997s for
even one violation don't strike me as particularly draconian, since if
you fix it in one case you've fixed it for all future cases. Basically,
anything that failed a WEDI/SNIP Type-1 compliance check should
completely fail.

Should WEDI/SNIP put together recommendations for granularity of
rejections based on the testing types or levels (e.g., Types 2 through
6) that failed compliance?

William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320

----- Original Message -----
From: "Kepa Zubeldia" <[EMAIL PROTECTED]>
To: "William J. Kammerer" <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>
Sent: Monday, 22 July, 2002 10:01 AM
Subject: Re: When is a claim a standard claim?


William,


When a provider sends 3,654 claims, and one of them is bad... I don't
think the providers are going to agree with the idea that it is OK to
reject all of them because the one bad claim in the file. If the other
3,653 claims are HIPAA compliant, can the payer refuse them? Isn't the
payer required to conduct the standard transactions?

Here is where the world of EDI and the world of business collide. It may
be an invalid 837 because it is tainted by a bad claim... but is that
what was intended when the Secretary adopted the 837?

Kepa

----- Original Message -----
From: "William J. Kammerer" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Sunday, 21 July, 2002 12:32 PM
Subject: Re: When is a claim a standard claim?


May I suggest that this thread be moved to just one or the other of the
WEDI/SNIP Business Issues or Transactions listserves?  Cross-posting (on
the WEDI/SNIP listserves) runs counter to Zon Owen's SNIP Listserv Usage
& Etiquette Guidelines (2002-04-01) at
http://www.mail-archive.com/business%40wedi.org/msg00311.html.

A recipient *may* reject an entire 837 transaction set if even only one
claim within is "tainted," but I doubt the law forbids more
"fine-grained" rejection.  As Kepa noted, many of the semantic issues
may not be discovered until well into the back-end, long after the
transaction set has been translated.  It may be difficult to "rollback"
thousands of correct "claims" within a single 837, for example, just
because the 3654th claim had a semantic inconsistency of the type Ellen
Falbowski mentioned: e.g., data from the CR1 Ambulance Transport
Information segment is missing when the payer finally discovers, deep in
the back-end, that an ambulance type Procedure Code was used.

Since the 824 (004050X166) allows for selective rejection, the payer, if
she prefers, could accept all but the erroneous claim (items), or all
claims for the particular patient which contained the erroneous claim
line item, or the entire 837 - depending on what floats her boat
(technically and business-issue wise). The provider (or billing service
or CH) would have no call to complain if the payer were to reject the
entire 837 since it is, in effect, non-compliant; but at the same time,
he certainly would not object to the selective rejection of erroneous
claims - which obviously allows him to get paid for the clean claims,
however.

The payer is not refusing to accept the standard transaction - the most
important part of the law, strongly emphasized throughout the TCS Rule.
And the provider still has not been given an artificial incentive to not
use the standard transaction, because he still hasn't gotten paid (for
the one invalid claim) even if the payer adjudicates the remainder of
the 837 (not because she is necessarily generous, but probably because
it's actually simpler for her). Everyone's happy:  why should the HIPAA
Stasi get involved?

William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320



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