Rachel, Steve can't use the 997 to "reject" an 837 Healthcare claims transaction merely because a "claim does not have service lines." Service lines (LX) are optional in the X12 837, so what's to reject with a 997? If that were the only problem with the 837, Steve's only choice is to "accept" the 837 with a positive 997, and then to follow-up with the 824 Application advice, 277U Claim Acknowledgment or some proprietary mechanism to alert the sender to HIPAA IG violations.
William J. Kammerer Novannet Columbus, OH 43221-3859 . USA +1 (614) 487-0320 ----- Original Message ----- From: "Rachel Foerster" <[EMAIL PROTECTED]> To: <[email protected]> Sent: Saturday, 12 February, 2005 10:54 AM Subject: RE: [EDI-L] Rejected Sets in 997 Steve, if you don't report the error via a 997 to your trading partner, how do you think they will learn about it and thus correct their side of the equation so that the error does not continue to occur? There are no HIPAA police! Failure to report errors only serves to ensure that they will continue to be repeated. Rachel Rachel Foerster & Associates, Ltd. 39432 North Avenue Beach Park, IL 60099 Voice: 847-872-8070 Fax: 847-589-8081 _____ From: Steve MacDonald [mailto:[EMAIL PROTECTED] Sent: Friday, February 11, 2005 11:03 AM To: [EMAIL PROTECTED]; [email protected] Subject: Re: [EDI-L] Rejected Sets in 997 A rejected Transaction set for us is any set that does not comply with our companion guide or has syntactical errors. I'm in healthcare, so if a transaction set has a group of claims and one claim does not have service lines, we reject the set. We cannot pay a claim with out a service line. However, that being said, we never send back a 997 showing that a Transaction set was rejected. We merely "fix the bad data". But don't tell the HIPAA police! Steve . Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Access the list online at: http://groups.yahoo.com/group/EDI-L Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/EDI-L/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
