Loading the data into tables / SQL including the Claim Adjustment Reason codes, RA remark codes and the Claim Status codes and then query out of the tables to get the information regarding payment, denials, etc.. This will enable you to manage your 835 data and work your denials far more quickly then you ever did with paper RA's as well as trend these items. There is a lot of data in the 835 file and the most important thing you can do is load it all into something that you can then extract the information from for posting payments, ra codes, trending, denial management, etc.
The codes and the definitions can be gotten from the Washington Publishing Company web site. I check it monthly for updates and keep our system current. www.wpc-edi.com/products/codelists Best of luck! Mary -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Scaccia, Kimberly Sent: Monday, October 01, 2007 10:22 AM To: [email protected] Subject: RE: [Talk] Aetna 835 file Kevin / Tom: I see you are having the same experience with the commercial 835s that I am... The reason codes from the payer are more specific than the ANSI Code... A Few Questions: Are you live with the 835 commercial? If so, how do you work around these reason code differences? (Specifically for payers who will discontinue sending the hard copy remits after ERA Go live)? Do you have a denials / underpay department? If so, how did they deal with the differences? Also, Kevin: Where were you on the Meditech L List? I have been asking these questions on the L for a long time (with no responses) :-) Kim Scaccia, System Admin Recovery Reimbursement Patient Business & Financial Services Halifax Medical Center 386-226-4590 opt 1 ext 2018 ________________________________ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Thomas McManus Sent: Friday, September 28, 2007 3:35 PM To: [email protected] Subject: RE: [Talk] aetna 835 file Hi, I have experience with this. The paper copy and the electronic copy are different. Claims are indexed on account number. Another big difference is the Reason Codes. The paper copy uses a more specific reason code the electronic uses the Ansi standard codes which can be vague. Tom McManus Tuomey Healthcare System Sumter, SC 803.774.8645 ________________________________ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Sexton, Kevin Sent: Friday, September 28, 2007 2:55 PM To: [email protected] Subject: [Talk] aetna 835 file This isn't really a BWS question.... The Aetna 835 file I am loading into Meditech doesn't match the hard copy they have been sending us. Has anyone else run into this. I was expecting patients A-Z but those patients are scattered all over various electronic files. -Kevin
