Fw: Addressing REF asterisk issue for UTSW
Changed my mind. I want to do a lower case x. ;-)
From my PDA
----- Original Message -----
From: Nancy Reed
To: Robert Warner; Mary Lou Short; Matthew Ketterman; Ginger Wright; Taryn Tresca; Cody Wisdom; Herve Devos; Cindy Allton; Mary Raines
Cc: Greg Ybarra; Mike Seisler; Tiffany Buchanan; Debbie Kennedy; Mary Anne Orenchuk; Cindy Allton; Jon McBride
Sent: Wed Feb 13 17:07:55 2008
Subject: RE: Addressing REF asterisk issue for UTSW
Debbie and I have cussed and discussed this issue and have come the the agreement that we will replace the "* - asterisk" with a capital "X".
The question mark caused the receiver implementation team concerns. The X may still cause payer rejects if the payer is dependant on the provider number for the REF segment that contains an asterisk. But either way - if we strip it or send an X - they will not get a valid provider number.
We are in agreement that we need to educate UTSW on the potential of payer rejects because we are not doing exactly what we did on THIN, but this is a quick solution that will allow them to submit claims successfully thru Availity at least one week earlier. Tiffany will be responsible for this communication.
Thanks all - I still love you Deb!!!
Nancy D. Reed
Director, Implementation Services
Availity, L.L.C.
Office: 972/383-6326
Nancy.Reed@Availity.com
The information contained in this e-mail may be privileged and confidential under applicable law. It is intended solely for the use of the person or firm named above. If the reader of this e-mail is not the intended recipient, please notify us immediately by returning the e-mail to the originating email address. Availity, L.L.C. is not responsible for errors or omissions in this e-mail message. Any personal comments made in this e-mail do not reflect the views of Availity, L.L.C.
________________________________
From: Robert Warner
Sent: Wednesday, February 13, 2008 1:56 PM
To: Mary Lou Short; Matthew Ketterman; Ginger Wright; Taryn Tresca; Nancy Reed; Cody Wisdom; Herve Devos; Cindy Allton; Mary Raines
Cc: Greg Ybarra; Mike Seisler; Tiffany Buchanan; Debbie Kennedy; Mary Anne Orenchuk; Cindy Allton
Subject: Re: Addressing REF asterisk issue for UTSW
I met with Debbie for Product input, and Product has directed us to use Ginger’s solution and replace the asterisk with a question mark. They are not comfortable with us removing data from the claim without permission.
We will begin testing the question mark today and are still shooting for this weekend’s release.
If we get complaints from payers we can address as we understand their requirements.
On 2/13/08 12:35 PM, "Mary Lou Short" <mshort@availity.com> wrote:
Matthew, Nancy, Mary and Cody recommend that we proceed with the change that strips the REF segment. They understand that it will not go in the weekend. Matthew said he would communicate this to Tiffany.
My other concern is this piece in Ginger's email:
Also, if we are going to be stripping these segments, as a clearinghouse on behalf of the submitter, we need a record of a request from the submitter indicating an understanding of the issue and agreement that we are doing this for them. It can be an in an email supported by a CR, doesn't have to be a TPA , contract or anything that formal especially when the submitter to us is another clearinghouse or vendor system. We need to make sure the provider's initial intent is being maintained.
Who will be coordinating the notification and gathering of an agreement for every submitter that we will be stripping the faulty REF segment for?
Mary Lou Short
System Analyst
Availity, LLC
904 470-4945
mshort@availity.com
--
Rob Warner
Availity, LLC
(904) 470-4973
rwarner@availity.com
The information contained in this e-mail may be privileged and confidential under applicable law. It is intended solely for the use of the person or firm named above. If the reader of this e-mail is not the intended recipient, please notify us immediately by returning the e-mail to the originating email address. Availity, L.L.C. is not responsible for errors or omissions in this e-mail message. Any personal comments made in this e-mail do not reflect the views of Availity, L.L.C.
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