Greetings,

Oh what fun you are about to have J

 

Looks like some folks had some good stuff bookmarked already so I'll stop my
searching.

 

Actually the files are pretty simple in concept - especially if this is in
regards to scripting the data in and I've learned enough about them to be
dangerous. They are exactly like HL7 -  well in the fact that they are a
hierarchical record layout where each line starts with a segment identifier
and has delimited fields therein. The DataStation can parse these files
using the X.12 file type. There are several examples in the Script library
under the DataStation heading geared towards these things.

 

For scripting payment posting, the level of knowledge needed is based on how
you have to post - just claim level or claim and line item detail. Most of
the stuff in the file is not needed for scripting. 

At the Claim Level, most of the data you'll need  is in the CLP segment -
(account number, what you asked for, what you got etc.)

The Service (line item) level stuff you start dealing with SVR, DTM and CAS
statements, what you did to the person, when you did it, and what you asked
for and got paid and why respectively.  Determining what to do for each
different denial codes in the CAS statement is the most annoying part of the
whole process. 

 

If this is "I need to change something in the file" so an automated import
routine works, that's a whole different ballgame and is <thankfully> WAY
outside my sphere of influence so to speak. You want to talk about levels
upon levels of details and significant minutiae.

 

Regards,

Thom

 

Thom C. Blackwell

Product Manager

Boston Software Systems

(866) 653-5105 ex 807

www.bossoft.com

 

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From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Parish, Jared
Sent: Tuesday, August 07, 2007 3:36 PM
To: [email protected]
Subject: [Talk] X12 Format

 

Howdy,

            Does anyone have any information on the X12 format?  I have a
bunch of remit files from payors that are in the X12 format.  I am having
trouble finding information on the internet about how to read or what each
segment means.  Does anyone have any good resources?

 

Thanks,

 

Jared Parish

 

Blanchard Valley Health System

1900 South Main Street

Findlay, Ohio 45840

 

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CareTech Solutions, Inc

 

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