Someone must have an idea...!?!
> -----Original Message-----
> From: Connie Lagneaux
> Sent: Monday, June 03, 2002 12:35 PM
> To: '[EMAIL PROTECTED]'
> Subject: 278 question
>
> Hi,
>
> I have a couple of questions related to the following scenario:
>
> A payor is providing a web based product to their providers for the
> submission of referral/authorization requests.
>
> 1. For the CR608 segment, does every certification type code have to be
> offered online? I think some payors may not want to do appeals
> electronically, especially when the PWK (Paperwork) segment has not been
> implemented (as described in the 278 addenda document). Additionally,
> some plans may not have "Extension" of ref/auth in their current business
> processes, but may instead require new requests be submitted.
>
> 2. Can the screen display "Plan or Payor" terms for Service Type Codes
> (UM03) ? This assumes that the mapping is appropriate and does not change
> the intent of the UM03 code. For example "Consult" for UM03 3,
> "Consultation" and "Specialist Visit" for UM03 99, "Professional
> (Physician) Visit - Office."
>
> 3. If no field currently exists on the entry screen for Location (Health
> Care Service Location) for those services where location is not implicit
> by the identified provider, would a resolution of the following be
> compliant: adding service types of (for example) hospice/home and
> hospice/inpatient on the screen AND behind the scenes for the transaction
> map to UM03 42 plus UM04 appropriate information per each service type
> just mentioned.
>
> thanks,
> Connie Lagneaux
>
>
>
>
>
