Joe, your mention of the idea of sending an unsolicited 277 whenever a claim is submitted reminds me that great minds can think alike! Here in New Jersey, where we have the HINT law, health plans will be required to reply to claim submissions with the 277, unless a provider indicates that they cannot receive and process this transaction. For these providers, the health plan is required to provide a mutually-agreeable way of acknowledging receipt on a claim-by-claim basis.
The HINT rule calls for an earlier version of the 277: X12.317 Version 003070, Release 7, sub-release O... ----- Original Message ----- From: "Barton, Joe" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, June 26, 2002 7:49 PM Subject: RE: an inquiry for a non-existing member > It may good customer relations practice to send an unsolicited 277 whenever > a claim is submitted. We do not have adjudication, once we receive a claim, > and valid, it is sent off for payment. An unsolicited 277 from us would let > our partners know either it passed edits, and is off to be processed for > payment (1-2 days) or if there was something wrong with the transaction. > > -----Original Message----- > From: Rachel Foerster [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, June 26, 2002 4:35 PM > To: [EMAIL PROTECTED] > Subject: RE: an inquiry for a non-existing member > > > Dave, > > The rationale is irrelevant. HIPAA requires that a 271 be returned in > response to the 270, and a 277 in response to a 276. > > Rachel Foerster > Principal > Rachel Foerster & Associates, Ltd. > Professionals in EDI & Electronic Commerce > 39432 North Avenue > Beach Park, IL 60099 > Phone: 847-872-8070 > Fax: 847-872-6860 > http://www.rfa-edi.com > > > -----Original Message----- > From: David Frenkel [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, June 26, 2002 10:48 AM > To: [EMAIL PROTECTED] > Subject: RE: an inquiry for a non-existing member > > > Alex, > I don't think you can rely on a provider to correctly enter membership > information correct 100% of the time. If you do not respond they may > not know that information was entered incorrectly and possibly delay > treatment. > It is also not of unheard of that a membership system is not up to date. > What rational would you have not to respond? > > Regards, > > David Frenkel > Business Development > GEFEG USA > Global Leader in Ecommerce Tools > www.gefeg.com > 425-260-5030 > > -----Original Message----- > From: Alex Chernyak [mailto:[EMAIL PROTECTED]] > Sent: Tuesday, June 25, 2002 8:25 AM > To: [EMAIL PROTECTED]; [EMAIL PROTECTED] > Subject: RE: an inquiry for a non-existing member > > Rachel, > Is it mandatory to respond (271 or 277) when a member is not found > on the membership system? Like status code 33 for 277 - subscriber & > subscriber id not found.... thanks > > > > ********************************************************************** > To be removed from this list, send a message to: > [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request. > > ====================================================== > The WEDI SNIP listserv to which you are subscribed is not moderated. The > discussions on this listserv therefore represent the views of the individual > participants, and do not necessarily represent the views of the WEDI Board > of Directors nor WEDI SNIP. If you wish to receive an official opinion, > post your question to the WEDI SNIP Issues Database at > http://snip.wedi.org/tracking/. > Posting of advertisements or other commercial use of this listserv is > specifically prohibited. > > > > > ********************************************************************** > To be removed from this list, send a message to: [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request. > > ====================================================== > The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. > Posting of advertisements or other commercial use of this listserv is specifically prohibited. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
