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Fee for Service THE OREGON DHS MMIS 837 DENTAL VERSION 4010A The Oregon DHS MMIS Companion Guide for 837 FEE FOR SERVICE Dental Claim and 837 Transaction Coordination of Benefits- Examples for Fee For Service



The objectives of this document are: *To clarify what information is needed by Oregon Dept. of Human Services (OR-DHS) where the guide indicates that the choice is dependent on the Payer. *To point out preferred selections for data elements where multiple alternatives exist. This Companion Guide supplements the 837 Dental Claim Implementation Guide Version 004010X097A1. In order to create an OR-DHS HIPAA compliant transaction, you must first meet the requirements of the Implementation Guide and then incorporate the payer (OR-DHS) specific requirements. OR-DHS processes all alpha characters in upper case. Do not use special characters. To properly process 837 transactions, OR-DHS requires only ONE transaction type in each transmission file beginning with the ISA segment and ending with the ISE segment. For example if the submitter sends Chargeable/FFS 837 transaction data for Professional, Dental and Institutional, there would be a separate file for each transaction (e.g. one containing only the 837P professional data, one containing only 837I institutional data and one file containing only 837D dental data.). For faster adjudication, OR-DHS requires one rendering (performing) provider per claim to avoid conflict between claim and line level data. Every effort has been made to prevent errors in this document. However, if there is a discrepancy between this document and the Implementation Guide, the Implementation Guide is the final authority

Year: 2010
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