[ Wednesday, April 28, 2004 ]


News on the TCS front: Not really a story, but sort of a recurring theme: I've been hearing more and more complaints from providers about WebMD and its portal/clearinghouse function, specifically regarding the fact that WebMD isn't fully compliant with the Transaction and Code Set rules. The specific things I hear are that in some data sets, the TCS rules require spaces for 3 digits, but the WebMD format only contains spaces for 2 digits. If physicians enter 3 digits, one digit gets dropped when the claim is translated to the X12 format.

Again, I don't know if this is true, and I have absolutely no experience in actually coding claims so I'm not certain whether this charge even makes sense. But as we start staring down the delayed-payment deadline for non-HIPAA-compliant claims to CMS this summer, it will be interesting to watch how this plays out. It seems like a whole lot of physicians and physician groups use WebMD's portal and clearinghouse functions, and if they all go to slow-pay on their Medicare and Medicaid claims, there should be some howling.

Jeff [11:23 AM]

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