Change Request Detail
No.
1070
Date
7/21/2008
Submitter
Type of Request
Pertaining to more than one, or not sure
Status
DSMO Process Completed
Business Reason
Update - to clarify:

In support of the X12 work on "005010X214 - 277 Health Care Claim Acknowledgement" and the work that WEDI has accomplished regarding the acknowledgements white-paper - I recommend that via the DSMO process,  the "005010X214 - 277 Health Care Claim Acknowledgement" transaction be adopted as a HIPAA National Standard by HHS.
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Original post:

I first made this request in 2002 (August 13th to be exact - see request number 708).

Over the years - the need to have a standard claim by claim acknowledgement of acceptance or rejection has become crystal clear. 

I receive almost as many formats of acknowledgements as I do payers who receive claims.  I have some who do, and others who do not do, 997 transactions.  For those who do them, about 2/3rds do them correctly, the other 1/3rd are worthless. 

Often, when I receive a 997 - i find that the batch of claims do not actually process into adjudication due to system issues - and I'm often not notified. 

In addition to the X12 work on "005010X214 -  277 Health Care Claim Acknowledgement", the work that WEDI has accomplished regarding acknowledgements is very important and I recommend that via the DSMO process, the WEDI Acknowledgement recommendations be moved forward and recommended for adoption as HIPAA National Standards by HHS.
Suggestion
Update - to clarify:

The "005010X214 - 277 Health Care Claim Acknowledgement" transaction should be approved by the DSMOs and recommended to the NCVHS to be adopted as a HIPAA National Standard by HHS.
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Original post:

Usage of the WEDI Acknowledgement recommendations and the X12  005010X214 -  277 Health Care Claim Acknowledgement.
DSMO Category
D
Recommendation
Disapprove. The DSMO recommends a single DSMO request must be submitted that names and outlines the appropriate use of the X12 acknowledgements for the HIPAA mandated X12 standards
Appeal Recommendation