Kay,

Thanks for the information. I don't mean to shoot the messenger, but how in
the %@&*%@ would a mere mortal know that "X12N, TG2, WG5" = "276/277?" Just
for fun, I tried to figure out which Task Group/Work Group would cover the
270/271 pair. I couldn't find any way to determine this other than going to
each TG/WG one-by-one and read what their responsibilities are. I think I
figured out that it would be TG2, WG1 - "Health Care Eligibility." But since
"The Purpose and Scope Document is currently unavailable" for that WG, I
can't be sure.

Surely there is a better way for the thousands of "participants" being
coerced into this exercise to find their way to the various resources
available. Can't someone, somewhere present this information in English?

-----Original Message-----
From: Kay Wyssbrod [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, April 10, 2002 11:17 AM
To: [EMAIL PROTECTED]
Cc: 'Kay Wyssbrod'; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: More 276/277 questions - they just keep surfacing



Lin, each meeting the dialin number changes due to the sponsor of the call.
I'd much prefer that those interested parties get the number by being on
the 276/277 listserv:
It's [EMAIL PROTECTED]  You can sign up by going to DISA.org and select
Accredited Standards Committee (X12), which will take you to a page where
you can either select X12N for Healthcare or you can start looking for
'quick links' which will get you to 'listserv signup'.  You want X12N, TG2,
WG5 for the 276/277.  Good luck!





"Quinkert, Lin" <[EMAIL PROTECTED]> on 04/10/2002 10:11:54 AM

To:    'Kay Wyssbrod' <[EMAIL PROTECTED]>, [EMAIL PROTECTED]
cc:    [EMAIL PROTECTED], [EMAIL PROTECTED]
Subject:    RE: More 276/277 questions - they just keep surfacing





RE: More 276/277 questions - they just keep surfacing

Hi Kay,

Would you post the 276/277 dial in number for those calls, please?� He (and
others) may not have it.

Thanks,

Lin Quinkert
GovConnect
HIPAA Practice Manager
(502) 905-1099

-----Original Message-----
From: Kay Wyssbrod [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, April 10, 2002 8:13 AM
To: [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: More 276/277 questions - they just keep surfacing


First of all, why didn't you use the 276/277 listserv?�� Also, you might
attend the 276/277 phone conference meetings on every other Thursday at 1
pm ET.
Secondly, if you also use the member id sent on the 276, that in
combination with the provider id should get you the limited claims that
would satisfy the privacy issue you raise.



"Hal Scoggins" <[EMAIL PROTECTED]> on 04/09/2002 12:20:03 PM

To:��� <[EMAIL PROTECTED]>, <[EMAIL PROTECTED]>
cc:
Subject:��� More 276/277 questions - they just keep surfacing




Folks,

Now that we're� wading deeper into the 276/277, more questions are
surfacing. Hopefully, someone� monitoring this listserv can help�us
address�them.

I'll post more as I� remember them, but the immediate question we have is
regarding the information� we send back to the originator of the 276
inquiry.

There is a large� possibility that we will be unable to precisely identify
the Provider specified� in the 276, since all we have to go on is a name
and TIN. This being the case,� it is possible that we may find multiple
claims that match the information� given. When this happens, the 276/277 IG
indicates that we should return the� status of all claims we find that
match the inquiry. But this raises questions� about privacy. Our impression
is that the IGs are written strictly from a� technical perspective, with
no�consideration of security and privacy� concerns. If we send back status
info about all matching claims, without being� sure of precisely who the
Provider is in the inquiry, are we going to be� violating some other piece
of HIPAA?

On a related� note; in the NM1 segment for the Service Provider, NM108
offers an "SV"� qualifier, with the note, "When the provider does not have
a National Provider� ID and Payer has assigned a specific ID number to this
provider this code is� required." We have assigned such an ID number to
each provider in our system.� While this would help us "nail down" the
provider, one of our claims processing trainers asserts that�it is
unreasonable to expect a provider to� keep track of every unique ID number
assigned to them by each of the potentially� hundreds of insurance plans
they deal with. While the IG appears to give us� carte blanche�- perhaps
even demands, if one gets right down to it� -�to reject any 276 that comes
in without that ID included, folks in our� office with significant
experience assure us that our assigned ID simply won't� show up on the 276.
So where does that leave us?�If we accept the 276 without that ID,� since
we have, indeed, assigned it, then we are accepting a non-compliant
transaction, since the note says that it is "required." But it seems that
we� will be rejecting 100% of the inquiries we receive, if we stubbornly
insist on� adhering strictly to the rules.

Any thoughts on either of these� issues?

Hal� Scoggins
SBPA Systems, Inc.
(281) 679-7272� x116

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