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Re: interpretation of situational stuff!
Yes. I am sorry, should have been more clear!
--- david frenkel < wrote:
> Chandra,
> just to clarify, I assume you are looking at the
> HIPAA X12N 837
> professional guide located on www.wpc-edi.com?
> Dave Frenkel
> EC/EDI Consultant
> ----- Original Message -----
> From: Chandra Damera <
> To: <
> Sent: Wednesday, October 17, 2001 2:24 PM
> Subject: [EDI-L] interpretation of situational
> stuff!
>
>
> > Hi all,
> >
> > How do I interpret some of the situational stuff
> > within the IG?!
> >
> > Example on the 837P(Pg.178), CLM11-5 says...
> > "Required if the automobile accident occured out
> of
> > the US to identify the country in which the
> accident
> > occurred."
> >
> > Now for instance, there is a claim that I receive
> from
> > the provider on which CLM11-5 is blank though it
> is an
> > accident claim occured out of US.
> >
> > Do I care to code this as a rule within my(payer)
> > system?! If yes, How do I identify this as a rule
> to
> > be coded within my system(Payer side) to reject
> the
> > claim?! There are ample amount of such situations
> > within the IG and I am wondering if it is left to
> the
> > providers' discretion to populate this element?!
> >
> > Regards
> > Damera.
> >
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>
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