RE: Payers and Optional Fields

[Robert Huffman]

I must assume that you meant to say a “situational” field rather than “optional”.  Then I will assume you are referring to an element in a PRV segment.  With the addenda references to the various 837 transactions, the taxonomy code is situational and the situation is that this data must be sent if the payer needs this data for adjudication of the claim.  Since this can be demanded by a payer in many places within the 837s, it seems best if providers attempted to send a proper taxonomy code every time they can.  No payer can refuse to accept the data and it is easier to just send it rather than writing modifications for every payer.   Bob Huffman CTGHS   -----Original Message----- From: Miriam Paramore [mailto:[EMAIL PROTECTED] Sent: Friday, February 28, 2003 9:08 AM To: WEDI SNIP Testing Subworkgroup List Subject: Payers and Optional Fields   This is probably the 100th time this has been asked... but bear with me.   Can a payer mandate that a provider put a certain value in an optional field?  Unisys has stated that it is requiring the taxonomy code in an optional field, and will not pay the claim unless that optional field is present.   I think this flies in the face of all things HIPAA standard.  Isn't that type of payer behavior expressly prohibited?  Still, other payers felt that they could get by with such a mandate as a "business rule" between trading partners.  Sounds like the dog is still getting wagged. Best Regards, Miriam J. Paramore President & CEO PCI: e-commerce for healthcare 9001 Shelbyville Road iTRC Building Louisville, KY 40222 502-429-8555 www.hipaasurvival.com =========================================== This email contains confidential information intended only for the named addressee(s). Any use, distribution, copying or disclosure by any other person is strictly prohibited.   --- 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/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-testing as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- 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/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-testing as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org