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Back  RFI # 582: Submitting a batch for the 278

Formal vs. Informal Help Informal Formal

Submitter

Nadine Farmer

Description

Assuming that we receive a 278 transaction with multiple authorization requests for a single patient, and not all requests finalize at the same time, can we respond to only those requests that have been processed by the authorizing agent in the batch mode or do we have to wait to all responses have been received. If so, how do you send the batch information with missing segments/responses.

Response

A 278 transaction with multiple authorizations can be answered with multiple 278 transactions as the answers become available. Use the BHT06 code value of 19 (Further Updates to Follow) an HCR01 code value of A4 (Pended) with and HCR03 value of E8 (Requires Medical Review). This will require a systematic process to keep track of the responses.
Submission 7/26/2007
Status Date 10/29/2007
Status F - Final
Primary References
Document 004010X094A1
Section1.3.4.3
Page15
Set ID278