Oh, I probably shouldn't have authoritatively said there were "implications," 'cause that sounds dishonestly like I have any idea what any of this is all about!
Since Loop 1000 shouldn't be used as an "audit" trail - and, indeed, it can't because nobody along the way can *add* instances of the loop (because 1000A and 1000B both have a loop repeat of 1 in the HIPAA IG) - they can only change Submitter or Receiver - then it seems like it is an application transaction representation of the two parties identified on the ISA: the sender (submitter) and the receiver. I can see how you would think "...that a 'repricer' would leave loop 1000 information on the repriced claim exactly the same as when he received it," but since the re-pricer opens the envelope and potentially changes stuff, I think we have a whole new "round" of sender and receiver. In Raj's first example, when the provider (or his BA) formats and sends an 837 to Raj (the re-pricer), the provider or billing agent is the submitter or sender (in both Loop ID-1000A and the ISA), and Raj said he is the receiver (in both Loop ID-1000B and the ISA). When Raj "re-prices" the claim, I agree with his intuition that he is no longer the "receiver," and he must change the loop somehow. I'd say he becomes the submitter (loop ID-1000A) and the payer should become the receiver. Because Raj is now the submitter, his name and telephone number can now appear in the 1000A PER segment, so the receiver can have a real person to talk to find out what the heck is going on! William J. Kammerer Novannet, LLC. +1 (614) 487-0320 ----- Original Message ----- From: "Christopher J. Feahr, OD" <[EMAIL PROTECTED]> To: "William J. Kammerer" <[EMAIL PROTECTED]>; "WEDi/SNIP ID & Routing" <[EMAIL PROTECTED]> Sent: Saturday, 23 February, 2002 04:07 PM Subject: Re: Submitter/receiver William, Despite the confusion, do you think that the Loop 1000 in the 837 has any value as a location for a "return" or "answering" EDI address for use by the entity identified in loop 1000 as the "receiver"? It did not sound like Raj was talking about the ISA, but what was the "implication" that you were thinking about re:addressing? -Chris Christopher J. Feahr, OD http://visiondatastandard.org [EMAIL PROTECTED] Cell/Pager: 707-529-2268
