Kepa, I have "complained" about frivolous requirements and erroneous edits for about two years. Payers and certification companies have these problems. A "revolt" won't help. With little time left, a more practical idea needs to be considered.
John W. Carter > -----Original Message----- > From: Thaler [mailto:Thaler] > Sent: Thursday, June 12, 2003 10:56 AM > To: WEDI SNIP Testing Subworkgroup List > Subject: RE: your post on submitting clean transactions > > > Too bad we have to use the word revolt - but some entities > only learn through education that is "enforced". There is a > complaint form at > > https://www.cms.hhs.gov/hipaa/hipaa2/support/correspondence/co > mplaint/default.asp? > > Patrice > > -----Original Message----- > From: Kepa Zubeldia [mailto:[EMAIL PROTECTED] > Sent: Thursday, June 12, 2003 10:08 AM > To: WEDI SNIP Testing Subworkgroup List > Subject: Re: your post on submitting clean transactions > > > Jeff, > > You ought to complain about this! The problem is that if > nobody complains, it > will never get fixed. Providers need to start a "revolt" > against these > frivolous companion guide requirements. The fragmentation of > the standards > into "custom" versions is probably one of the biggest threats > that HIPAA has, > and one of the many reasons why the implementation is going so slow. > > Kepa > > > > > On Thursday 12 June 2003 06:49 am, [EMAIL PROTECTED] wrote: > > Kepa, > > > > As a provider, I'm seeing quite the opposite of what you > say about clean > > transactions, here in the real world. > > > > Regardless of the fact that federal regulation require a > payer to accept > > a clean X12 claim, they will do what works for them. Our > local Medicare > > carrier has been pretty good at sticking with the IG, but > the local Blues > > here came out with a 2" thick binder for the companion > guide documents. > > Many of the segments are in absolute contradiction to the > IG. When I > > called them on this, the response was simple...."follow the > companion > > guide, or else the claims will get bounced on the front end > edits. And > > since the front end edits are done before the claim enters > our processing > > system, if its noncompliant, it doesn't get into the > system." (Legal > > speak for "we never got your claim".) > > > > Never bothered to complain to CMS, as I need to get paid; > not worry about > > the IG implementation. For most small providers, the 800 > lb gorrilla > > leads the way. > > > > The software just winds up with a lot more conditional > branches that it > > should have, but the cash flow continues. We've been > sending X12 claims > > to Medicare and Blue Shield now since April, with no problems so far > > (knock on wood). > > > > Jeff Pinsky > > PTFILE Systems > > > --- > 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 > N4zrryjNyzz�vzz > j|y!<?y!<jjyNzzurzjr~rrvrz{zj~zzzrjrz?mjjnnRnbujjyz > ??ryrz?izjizvynRn --- 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
