Rachel, I agree this thread should be moved to X12 Insurance TG2 WG5, where the v4040 277 Front-End Acknowledgment is being discussed.
A quick note: NJ HINT does require a 277 Unsolicited v3070 standard to be replied to any claim with adjudication issues. This will be re-clarified in a NJ meeting next month. Please redirect any other questions to X12 Insurance TG2 WG5 or to me directly, if applicable. Dominic Saroni Associate Rachel Foerster & Associates, Ltd. Professionals in EDI & Electronic Commerce 39432 North Avenue Beach Park, IL 60099 Phone: 312-925-4525 Fax: 847-872-6860 http:/www.rfa-edi.com -----Original Message----- From: Rachel Foerster [mailto:[EMAIL PROTECTED]] Sent: Thursday, June 27, 2002 12:08 AM To: 'WEDi/SNIP ID & Routing' Subject: RE: Transactions Listserve: Unsolicited 277 in response to claim submissions NJ's HINT law has been on their books for almost 2 years, so the requirement for providers to file claims on behalf of their patients is not new knowledge. And obviously NJ lawmakers didn't view it as nonsense. And, how did you make the leap from a provider being required to file a claim on behalf of the patient to an unsolicited 277 transaction. NJ HINT doesn't require it, nor does HIPAA. I trust you're not trying to take on the NJ legislature on their laws here, since that is most certainly out of scope. This is not an issue that WEDi SNIP Routing should be taking up. Out of scope!!!!! Rachel Rachel Foerster Principal Rachel Foerster & Associates, Ltd. Professionals in EDI & Electronic Commerce 39432 North Avenue Beach Park, IL 60099 Phone: 847-872-8070 Fax: 847-872-6860 http://www.rfa-edi.com -----Original Message----- From: William J. Kammerer [mailto:[EMAIL PROTECTED]] Sent: Wednesday, June 26, 2002 9:07 PM To: WEDi/SNIP ID & Routing Subject: Transactions Listserve: Unsolicited 277 in response to claim submissions Here's a new one on me: Cynthia Korman told us on the WEDI/SNIP Transactions Listserve of NJ's HINT law. How is the payer going to know how to get the 277U back to the provider? And what's this nonsense about providers having to file claims on behalf of the patient? What if this is the first time the provider has ever dealt with the patient's insurance company? Is this another example of lawmakers writing rules which are almost impossible to implement? Will the Healthcare CPP Registry be of any help here? See the Health Information Electronic Data Interchange Technology Act ("HINT") at http://www.state.nj.us/dobi/pn01_63.htm. Note especially: The Department also notes that the Act does not require providers to implement electronic systems for the processing of health care transactions. The Act merely states that 12 months after HINT becomes operative all health care providers shall file claims on behalf of patients unless the patient elects to personally file the claim. It should be noted, however, that the Act does provide incentives where providers file electronically. For instance, electronically filed claims must be paid in 30 days while paper claims must be paid in 40 days. Electronically filed claims must be acknowledged by payers within two days of receipt, and paper claims within 15 days of receipt. Any discussion? Yoo-hoo!! Anyone? Or is this too far off-topic from the usual run of anti-SPAM vigilantism? William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ----- Original Message ----- From: "Cynthia Korman" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, 26 June, 2002 09:27 PM Subject: Unsolicited 277 in response to claim submissions Joe, your mention of the idea of sending an unsolicited 277 whenever a claim is submitted reminds me that great minds can think alike! Here in New Jersey, where we have the HINT law, health plans will be required to reply to claim submissions with the 277, unless a provider indicates that they cannot receive and process this transaction. For these providers, the health plan is required to provide a mutually-agreeable way of acknowledging receipt on a claim-by-claim basis. The HINT rule calls for an earlier version of the 277: X12.317 Version 003070, Release 7, sub-release O... ----- Original Message ----- From: "Barton, Joe" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, 26 June, 2002 07:49 PM Subject: RE: an inquiry for a non-existing member It may good customer relations practice to send an unsolicited 277 whenever a claim is submitted. We do not have adjudication, once we receive a claim, and valid, it is sent off for payment. An unsolicited 277 from us would let our partners know either it passed edits, and is off to be processed for payment (1-2 days) or if there was something wrong with the transaction. discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
