See the message, below, posted to the Transactions listserve. Even though Raj is probably referring to the confusing Loop ID-1000 in the 837 (Submitter and Receiver), his question has implications for use of the ISA sender and receiver fields for each hop from provider to repricer to payer.
William J. Kammerer Novannet, LLC. +1 (614) 487-0320 ----- Original Message ----- From: "Thuppanna, Raj" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Friday, 22 February, 2002 06:22 PM Subject: Submitter/receiver I have a question about submitter/receiver in a re-pricing model. In this example, we receive the claim for re-pricing. We are not destination payer. According to 837 IG in the scenario where a provider (or providers billing service) sends the electronic claim to us for re-pricing, the provider is the submitter and we are receiver. We then re-price the claim and forward it to destination payer. Who should be the submitter and receiver when we forward the claim to payer? My understanding based on IG is that submitter and receiver should remain same when we forward the claim to destination payer. But It doesn't make sense for us to be receiver here. In the same model, it we get a paper claim from a provider and then forward the re-priced claim, who should be submitter and receiver? My understanding is that we are the submitter and destination payer is the receiver. Any help is appreciated Thanks Raj Thuppanna 770 444 4468 ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request.
