Falls Church, VA, July 27, 2009 – The Accredited Standards Committee (ASC) X12N (Insurance) has announced that drafts of the 005010X291 Health Care Predetermination: Professional (http://store.x12.org/x291) and 005010X292 Health Care Predetermination: Institutional (http://store.x12.org/x292) Implementation Guides are available for public download, review and comment.
The Health Care Predetermination Implementation Guides describe the use of the ANSI ASC X12 Health Care Claim (837) transaction set for the submission and transfer of predeterminations to health care payers and clearinghouses. The authors especially solicit comments on what is needed to support predetermination or estimate requests for property and casualty (including workers’ compensation) and ambulance and other transport-related services.
The two Health Care Predetermination Implementation Guides, 005010X291 and 005010X292, are not counterparts of any that have been adopted under HIPAA, and no official discussions regarding any such adoption are presently contemplated. At this juncture, only voluntary use of these TR3s is anticipated.
Participation in X12's public comment period for the two Health Care Predetermination Implementation Guides is open to all interested, whether or not they are members of ASC X12, representing the highest leverage opportunity individuals outside of the authors to impact this document.
Comments on the drafts may be submitted via an on-line conference at: http://www.wpc-edi.com/conferences/tg2/implementationguides.
The public comment period for these guides lasts from July 23, 2009 through August 22, 200, at 5 p.m. Eastern Daylight Time.
Public comment on these Implementation Guides is a key step in the X12 Technical Reports, Type 3 (TR3) publication process. This is X12's only unconstrained public comment period. The authors of these guides will consider all comments during and following the public comment period. For a complete understanding of changes being suggested and/or made to these guides, reviewers should monitor the on-line conferences during the public comment period and consider all author responses, prior to the Informational Forums. Official authoring work group responses will be posted to the on-line conferences at least 15 days prior to the Informational Forums.
An announcement of the Informational Forums will be made later. The Informational Forums, held during an X12 Trimester Meeting, represent X12’s final opportunity to comment and generally represent modifications based on the public comments received. The guides are then finalized for movement through the Insurance Subcommittee (X12N) and X12 publication approval processes.
About ASC X12
Celebrating 30 years of Business Process and Technical Expertise in the Development and Adoption of Electronic Data Exchange Standards
The ASC X12, chartered by the American National Standards Institute (ANSI) in 1979, develops EDI standards and documents for national and global markets. With more than 315 X12 EDI standards and increasing X12 XML schemas, ASC X12 enhances business processes, reduces costs and expands organizational reach. Members include standards experts from health care, insurance, transportation, finance, government, supply chain and other industries. To participate in ASC X12’s vital standards-setting role, visit www.X12.org, or call 703-970-4480.
The Data Interchange Standards Association (DISA), Secretariat to ASC X12, is home for the development of cross-industry e-business interchange standards that help organizations improve business methods, lower costs and increase productivity. DISA provides administrative and technical support to ASC X12. For additional information, visit www.disa.org, or call 703-970-4480.