We have a vendor who requires us to use an 834 as a response file to their original 834 to us. One of their requirements is that we populate BGN06 with the value in BGN02 from their original transaction and that BGN01 remains = "00" This is failing our compliance checker with a SNIP level 2 error stating BGN06 should not be used when BGN01 is not one of '15' or '22'. When we posted this bacl to the vendor they told us that the error is a result of your validator. Can you please clarify if this is in fact a compliance issue?
The 005010X220A1 Benefit Enrollment and Maintenance (834) Technical Report Type 3 (TR3) defines in Section 1.1 Implementation Purpose and Scope that “The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer.” Section 1.3.1 Other Usage Limitations further clarifies that “Any response back to the Sponsor from the received transaction is outside the scope of the 834 and is the responsibility of the sponsor and payer.”
This usage is outside the scope of the TR3 and is a proprietary implementation of the 834 and must be identified as such in GS08 and ST03 with a value other than "005010X220A1".
Requests to address business needs not currently met by ASC X12 Technical Reports may be submitted at http://changerequest.x12.org/