Change Request Detail
No.
833
Date
8/15/2003
Submitter
Type of Request
Pertaining to more than one, or not sure
Status
DSMO Process Completed
Business Reason
With the current transmission flat file 997, The carrier transmitts immediately after receiving a transmission information which designates errors by record line, claim segment and data element. However you do not identify which data refers to which data that was transmitted. In other words you tell the sender that he has errors but not what claim it pertails to. With large numbers of claims involved we are currently reduced to counting lines and /or calling the carrier and asking for help in identifying the errors.

It would be far simplier if you added the claim number/claim account number or even the patient name for identification purposes.
Suggestion
No suggestion was entered.
DSMO Category
D
Recommendation
Disapprove. This request is out of scope of the DSMO process because the 997 is not a HIPAA standard transaction. The DSMO offer the following information from X12N: The 997 is intended to deal with X12 syntax and not the business logic or content of the transactions set(s) contained in the Functional Group. Please note, the 997 is also used by industries other than health care. X12C is working on standard acknowledgment and the requestor’s input is welcome.
Appeal Recommendation