A central directory of some kind while important, would not necessarily make it easy to determine a particular payer's ID number. As anyone who has attempted to match their payer dictionary against a clearinghouse payer list knows, the payer name on the ID card is not always what one finds on the list. I like the idea of requiring health plans to publish the number on their ID cards. That way the provider doesn't have to change much about their process today. But even with that resolved, we still need to get past payer specific trading partner agreements and EDI enrollment. Knowing what payer ID to use is the least amount of the work if payers start making TPA's and enrollment standard.
Marcallee Jackson Long Beach, CA 562-438-6613 -----Original Message----- From: Christopher J. Feahr, OD [mailto:[EMAIL PROTECTED]] Sent: Saturday, January 19, 2002 3:20 PM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: RE: Payor identification codes for 837I Regarding the unique routing ID for the payor (NAIC code?)... whatever it is, MUST be maintained in a central directory. At least, that's my vote as a small provider. People walk through my door unpredictably with all sorts of insurance plans and if it was EASY/PAINLESS to determine where to send a standard elig. query and/or a std. claim, then I'd be less inclined to require the patient to pay cash and duke it out on his own with his insurance company. A central payor address/routing directory seems like a vital component. -Chris At 03:09 PM 1/19/02 -0600, you wrote: >William, > >I don't think it's unreasonable to believe that many large instituional >providers submit claims to dozens, if not more, payers. I suspect that only >smaller providers that may be in more rural rather than large urban centers, >might deal with only a few payers. > >Thus far the discussion here seems to be between William and me. I'd much >prefer to hear from the actual players in these various scenarios: >providers, payers and clearinghouse. > >Rachel > >-----Original Message----- >From: William J. Kammerer [mailto:[EMAIL PROTECTED]] >Sent: Saturday, January 19, 2002 12:51 PM >To: WEDi/SNIP ID & Routing >Subject: TCS: Payor identification codes for 837I > > >An interesting question re: Identifiers posted to hipaalive yesterday >causes me to come up with some of my own: > >This request reminds me of the periodic queries for directories of SCAC >codes that arise on the general purpose EDI-L mailing list: I always >wonder why people just don't ask their (relatively few) carriers for the >respective codes. Likewise, wouldn't a provider (even an institutional >one) be dealing as a participating provider with relatively few payers, >and hence only need those payers' NAIC codes? - i.e., would there really >be a need for a NAIC directory? Does COB complicate the matter? - i.e., >the secondary payer may be known only by name, assuming it's provided by >the patient. Is the NAIC commonly used as the receiver (or sender) >field of the ISA? > >Rachel: corral me in if I'm making any unwarranted assumptions! > >William J. Kammerer >Novannet, LLC. > >----- Original Message ----- >From: "Jeffrey Young" <[EMAIL PROTECTED]> >Sent: Friday, 18 January, 2002 11:12 AM >Subject: RE: TCS: Payor identification codes for 837I > > >The National Association of Insurance Commissioners issues an identifier >to nationally significant carriers. Their database enumerates over >6,000 indemnity and managed care life, accident and health care payers. > > -----Original Message----- > From: Marcus E. McCrory [mailto:[EMAIL PROTECTED]] > Sent: Friday, January 18, 2002 6:48 AM > To: HIPAAlive Discussion List > Subject: [hipaalive] TCS: Payor identification codes for 837I > > > *** HIPAAlive! From Phoenix Health Systems/HIPAAdvisory.com *** > Regarding 2010BC-NM109 (page 127) & 2330B-NM109 (page 410) of the 837 >institutional guide, what currently serves as a central repository for >all of the payor identification codes for different plans/payors >throughout the country in the absence of a national identifier? Am I >missing a previously published list or well known resource? > > Thank you Christopher J. Feahr, OD http://visiondatastandard.org [EMAIL PROTECTED] Cell/Pager: 707-529-2268
