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Technical Workgroup

Page history last edited by PBworks 15 years, 7 months ago

Home Education/Outreach Workgroup Etiquette

Homepage for the Technical Workgroup (This page is still under construction)

This page represents the consolidation of three previous workgroups (Attachments, Connectivity and Technology/Implementation) that are now subworkgroups included on this page. The old wiki pages for those workgroups have been preserved for historical reasons but are now inactive. All the technical issues will be developed by this workgroup, and the results and recommendations will be passed to the Education and Outreach workgroup so they can be published to the world.

The discussion and development of these issues will be mostly using mailing lists, the Comments section of this page and other pages created for specific discussion topics, and postings on this wiki pages and associated pages. Once a week, on Thursday morning at 10:00 Central, there is a conference call to address those topics that need to be addressed "in person". Take a look at the Etiquette document for recommendations on how to use our time the most efficiently. Feel free to contribute your content or send a request to post content to sebinrsa@gmail.com.

Next conference call on Thursday September 18th at 10:00 Central, 60 minutes

Call-in number: 616-597-8000

Access code: 505468#

Please update your Participant Information for the minutes. To add/change information, please send an email to Kepa Zubeldia.

We will continue discussing the topic of Payer ID and connectivity, using some of the information in these pages and the FAQ and the Enumeron proposal. We are preparing an educational paper on this topic. And we are looking at http://WorkCompCoverage.wcd.oregon.gov/ and https://www.ewccv.com/cvs/ as reference points. We are also working on a Payer ID query process to be used by providers in identifying where to send the eBills and what Payer ID to use.

For the call on July 24th we will be discussing SeBin Electronic Billing Volume Flow Obstacles Analysis.doc and also Submission and Delivery of Electronic Workers (draft final).doc. Please review them before the call.

By clicking on the following links, you will be taken to the appropriate subworkgroup section of this page:

Technology/Implementation Connectivity Attachments

Technology/Implementation Subworkgroup

View the Purpose of the Technology/Implementation Subworkgroup

SeBIN Tech_Imp WG Purpose Statement.doc

SeBIN Submitted Technology/Implementation Issues

Issues
New	Payer ID support proposal from Enumeron. Will be posted here when received. SeBIN Issue - RARC FirstAidResponse.doc (revised version from Don)
In Progress	SeBIN Issue - NCPDP guidance.doc The NCPDP is developing An Overview and Comparison of WC Pharmacy Services.doc for guidance about the use of real-time and batch transactions for Workers' Compensation. Your comments are requested as soon as possible, since the NCPDP discussion starts on May 3rd. Please send your comments to Sue Thompson <sthompson@ncpdp.org> Fax Cover Sheet Issue.doc Requesting samples of Fax Cover pages from all payers and clearinghouses, to be submittedto SeBIN before March 27. During the March 27th meeting we will discuss this topic. The submitted samples are here. And this is the first draft for discussion next week: SeBIN Attachments Sample Cover Page v1.pdf SeBIN issue - Stop pays.doc has been referred to the HIPAA Interpretation Portal for guidance. SeBIN_Issue - Zero_Charges 12-19-07.doc
Ongoing	SeBINIssue-835onAppeals12-10-07.doc (The X12 meeting in Seattle approved new adjustment reason codes in Seattle and modified existing codes.) The 835 Adjustment Reasons and Payment Remarks have been assigned their own work areas where we can track each one of the codes and the progress in their resolution. NEW: The codes approved by the Codes Committee in Seattle on 1/27/08 have now been posted on the WPC-EDI web site. Texas Workers' Compensation Requirements.pdf Per Rosanna, "This is what the e-bill guide reads regarding appeals/reconsiderations. Rule 133.250 can be found in the purpose for the Attachment Workgroup. Section 5. pg. 22. The primary affected state is Texas ... over time, we can add or ammend what other states do for this situation."
Closed	SeBIN Issue - PWK Segment 3-27-08.doc and SeBIN Issue - PWK Segment 3-27-08_resolved.doc SeBIN Issue - TPB Scenario 3-27-08.doc and SeBIN Issue - TPB Scenario 3-27-08_resolved.doc SeBIN issue - Non TX claims.doc and SeBIN issue - Non TX claims_resolved.doc Attachments Solicited vs Unsolicited.doc and the recommandation from SeBIN for educating the payers and providers on this issue Attachments Solicited vs Unsolicited resolved.doc. And the "official list of unsolicited attachments List_of_Required_Documentation.doc required by Texas regulations. SeBIN Issue - 835 for Paper Bill 2-22-08.doc and a response from the TDI resolving this SeBIN_Issue_-_835_for_Paper_Bill_resolved.doc SeBIN_Issue_-_NPI_for_Mult_Entities_Scenario.doc For information only. This needs to be supplemented by the WEDI white papers on NPI. Jurisdictional_835_codes.doc Addresses how the 835 is to convey the State code for the state of jurisdiction, so the juristictional requirements for notifications and messages can be incorporated "by reference" in the 835. Approved for forwarding to TDI. SeBIN_Issue_-_Report_Trans_Code_on_PWK_Seg_2-14-08.doc How the PWK segment is to indicate that the attachments were image files uploaded to a web site instead of being sent by paper or fax. Approved for forwarding to TDI. Reconsiderations resolved.doc Addressing the difference between corrected eBills and reconsiderations. Approved for forwarding to TDI. Additional Ambulance patients issue Ambulance Number of Patients.doc and the resolution from X12 in Seattle Ambulance Number of Patients resolved.doc even though non-emergency transport is not reimbursable in Texas. Jurisdictional State and Accident state Issue Jurisdictional State Indication.doc and the resolution from X12 in Seattle Jurisdictional State Indication resolved.doc ready for adoption by TDI in the Companion Guide. Billing_Provider_ID_for_835.doc and the solution from TDI for discussion Billing_Provider_ID_for_835 resolved.doc now ready to be changed in the TDI Companion Guide. SeBINIssue-835RequiredFields11-29-07.doc See the feedback on this issue from Bob Poiesz and the official X12 HIPAA Interpretation Portal Resubmission Type.doc TX 837-CLM19 Issue-1 resolved.doc The resolution is to use a "Condition Code" to indicate the resubmission for 837 Institutional, and to use the Condition Code in the K3 segment of the 837 Professional or the NTE segment of the 837 Dental. GS08-1 resolved.doc The resolution is to use the "A1" in GS08 as the standard, and two willing trading partners are always allowed to use "WC" or other designator in GS08 by mutual consent.