In this case the word 'unsolicited' refers to the type of 277 transaction being used. An 'unsolicited 277 transaction' is being used as opposed to a 'solicited 277 transaction'. Under X12, the only way to solicit a 277 is via a 276 (not an 837).
I think it is clear to everyone by now that there are definite holes in the HIPAA transaction map. I don't think that is a realistic criticism however. Rome wasn't built in a day; creating a complete web of standardized transactions is a long process. Personally, I've got enough on my plate (although we are implementing the unsolicited 277 Front-end acknowledgement as part of our HIPAA suite - we've got some tests going and the providers love it). Jan Root "Fuller, Jill" wrote: > Responding to the 837 Claim with a 277 is not an unsolicited > response. The 277 is the appropriate HIPAA document to respond with initial > Claim Status of Claim Acceptance or Rejection to the Claim Submission. > > Why would HIPAA want to perpetuate the practice of Claim Submission > Accept/Reject response from Payors in a multiplicity of proprietary > formats/code sets to the HIPAA IG 837 Claim submission? > > Or, does HIPAA expect Providers to immediately map 837 Claims to a > 276 Claim Inquiry, and submit the 276 right behind the 837, to force the > Payor to Respond in the HIPAA IG 277 to determine Claim Acceptance? Thus, > doubling the transaction volume for both Payor and Provider. > > Did HIPAA just completely missed the boat here or what? > > Thanks, > Tim Muehlberg > Texas Health Resources > EDI Technologies Implementation/Support > Phone (817) 462-6560 > Fax (817) 462-2506 > Email: [EMAIL PROTECTED] > > -----Original Message----- > From: Rachel Foerster [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, June 26, 2002 7:03 PM > To: [EMAIL PROTECTED] > Subject: RE: an inquiry for a non-existing member > > Joe, > > I would agree that it would be good customer relations to send the > unsolicited 277....this, of course, would have to be in agreement with the > customer that they are able to receive such a 277. > > The original question was whether it was mandatory under HIPAA to return a > 271 to a 270 and a 277 to a 276. And I answered in the affirmative. HIPAA > requires that a 270 and 276 be responded to appropriately. The unsolicited > 277 is not a HIPAA transaction, and as such, is neither prohibited nor > required by HIPAA. > > 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: Barton, Joe [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, June 26, 2002 6:49 PM > To: '[EMAIL PROTECTED]' > 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. 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