Morning all,
Question from an 837I tester... I have been testing with a few of CMS's FIs
and have been getting different information with each test. Granted I am
using data from providers that the FI would serve; but, are we still hitting
a moving target? I am getting conflicting information about when to use
what elements. And these testing environments one would expect to be the
same. They are all CMS FIs.
Case in point:
I have tested with UGS and AdminaStar. Both tests have cleared front end
edits and have received approval from AdminaStar for the transmission
elements described above. In these 2 elements I do not supply any data as
they are optional fields. I supply the Medicare policy number in the NM109
field as described in the SBR03 notes.
The kicker on the latest testing, the intermediary says that one of these 2
fields is required. They are indicating that if SBR03 is empty then SBR04
must be filled. The question I have is, is this true? I read the notes
from SBR04 and it reads "Used only when no group number is reported in
SBR03." Now I'm not sure about their interpretation of English, but I dont
see the words "must be used if" in that sentence. Am I wrong? How do I
push back on this?
Like I said... I feel like I have been trying to hit a moving target. And
if the target is moving... then my program must move too. Now do I go back
and retest? Granted its only one now... but later it could be dozens.
Please excuse the small rant... but could use some help.
Thx,
BCY
Brian C. Young
Accu-Med Services Inc.
An OmniCare Company
Milford, OH 45150
513.831.1207
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