The Health Information Network (THIN), which is now called Availity, has several response reports that will assist in managing the claims you file electronically. You'll find the new daily reports easy to use and easy to access. The reports acknowledge accepted claims as well as the rejected ones. The Real-Time and Daily Confirmation reports also are available as a flat file so that you and your software vendor can reformat to your specific needs for automatic response posting.
If you have questions about THIN (Availity), or to begin receiving the new reports along with your current reports, contact the THIN Electronic Data Interchange Helpline at (877) 334-8446, or the Availity Customer Service Center at (800) 282-4548.
Want to avoid the electronic claim rejection pitfall and increase your cash flow?
Your first step is to ensure your staff is working THIN (Availity) response reports on a daily basis. Claims that are successfully transmitted to THIN are edited at the time of transmission. Most of the edits are syntax edits (such as invalid dates or non-numerical data in numerical fields). THIN (Availity) also performs some payer-specific edits at the request and discretion of the payer.
THIN (Availity) response reports (sender code: SCLR00) usually are available immediately after a successful transmission. THIN (Availity) will either accept claims for continued processing or reject claims back to the submitter via the response report. THIN (Availity) then forwards accepted claims to payers through direct or indirect connections to THIN (Availity). Payers and payer contractors are required to return responses only on rejected claims. If the payer or payer contractor does not return responses, the claims will be processed and acknowledged by the payer's adjudication system.
If payers or their contractors reject claims, the reject on the response report is usually the only notification of claim rejection the submitter receives. This is why it is extremely important that you:
- Understand the flow of the claims from your office to THIN (Availity), and eventually to the payer;
- Know how to read and interpret response reports; and
- Correct and resubmit any rejected claims electronically.
If you have questions about THIN (Availity), contact the THIN Electronic Data Interchange Helpline at (877) 334-8446 or the Availity Customer Service Center at (800) 282-4548. Refer to the THIN Web site for more information.
Content reviewed: 3/16/2007
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