Michael,
Would you mind if I call to speak with you in person about your issues
with the Meditech Claims module?
Thanks,
Kevin
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Michael Jobin
Sent: Monday, June 09, 2008 5:58 PM
To: [email protected]
Subject: Re: [Talk] 835 files
We purchased MT interface, which still has limitations. I may
end up scripting some anyway.
Michael Jobin
CIO
Natividad Medical Center
713.545.2314
On Jun 9, 2008, at 11:12 AM, "Sexton, Kevin"
<[EMAIL PROTECTED]> wrote:
BWS'ers,
Is anyone scripting in all of their 835 files to
Meditech Client Server (our HIS)?
We are debating buying Meditech's Claims module ($90K+)
or going to the trouble of scripting all of them and then having to
support the scripts on a daily basis. I'm hoping to find someone who has
been down that road.
Thanks,
Kevin J. Sexton
540-316-5504
Manager- Business Information Systems
Fauquier Hospital
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Scaccia, Kimberly
Sent: Monday, October 01, 2007 11:54 AM
To: <mailto:[email protected]>
[email protected]
Subject: RE: [Talk] Aetna 835 file
Thanks Mary: However, I am able to extract all
the codes from the raw 835 file from Meditech. My problem is that the
payer legacy codes are more specific than the ANSI codes; therefore, as
a fictitious example:
Aetna sends me an 835 with reason code 16 which
means: Claim/service lacks information which is needed for adjudication.
The paper EOB would provide me with specifics on
what is truly needed. I.E. Patient needs to provide Form XYZ, or
patient needs to update information, or clinical documentation
necessary, etc.
This is what we have seen in trying to take our
commercial remits live. Since we have an extensive denial/underpay
department already in place, the 835s and lack of specificity has made
it very difficult to move forward... it is like we are actually loosing
data in most circumstances.
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 Thompson, Mary
Sent: Monday, October 01, 2007 11:44 AM
To: <mailto:[email protected]>
[email protected]
Subject: RE: [Talk] Aetna 835 file
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.
<http://www.wpc-edi.com/products/codelists>
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: <mailto:[email protected]>
[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: <mailto:[email protected]>
[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: <mailto:[email protected]>
[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
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