Mimi,

Providers have an easy solution: They can produce a claim with the "minimal 
data set" concept described in the Transactions Final Rule and know that the 
payer is required to accept that claim and pay it. Perhaps before writing a 
"companion document" it should be required to read the Transaction Final Rule 
again, with an emphasis on the minimal data set and the maximal data set.

Thoughts.

Kepa




On Friday 15 November 2002 12:15 pm, Jensen, Christine wrote:
> Mimi
> I'm with you on the guides we can't get.  One of my many nightmares about 
transactions is we'll receive a companion guide from a payer the middle of 
September and won't have time to do proper analysis and testing.  I had an 
opportunity a number of months ago to testify to a HHS Advisory Committee on 
Regulatory Reform regarding T&CS and addressed companion guides and the 
implications of no deadlines for getting them to providers, but since guides 
aren't even addressed in the rule, there seem to be no options.  
Unfortunately, I don't think there is any real "clout" that can be wielded by 
providers to encourage payers to make these available soon.  I don't know 
that lack of timeliness will create additional chaos, but it certainly 
doesn't make the process any easier.   
> 
> Christine Jensen
> HIPAA Project Manager
> Denver Health
> 303.436.7942
> 
> 
> -----Original Message-----
> From: Mimi Hart [mailto:HartAM@;crstlukes.com]
> Sent: Friday, November 15, 2002 10:43 AM
> To: WEDI SNIP Testing Subworkgroup List
> Subject: Re: Payer Edits (Type 7 or 8)
> 
> 
> We need another "level" to test like ...well never mind. None of the
> payer specific edits I have seen so far in companion documents appear to
> reach the level of blatantly disregarding or changing what the Imp
> Guides states. Instead, they are "we don't use this, so if you send, we
> will ignore " or, "we will take this, but we won't validate on it", or,
> the IG gives you 6 choices, we only pay on 4, or the IG says this can be
> up to 20 characters, our payer specific # is only 13.  What concerns me
> are the companion documents I cannot get at this time....
> 
> 
> Mimi Hart ӿ�*
> Research Analyst, HIPAA
> Iowa Health System
> 319-369-7767 (phone)
> 319-369-8365 (fax)
> 319-490-0637 (pager)
> [EMAIL PROTECTED]
> 
>  
> 
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The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions 
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you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
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