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Is it a violation for an information source (payer) to send a single 277 claim acknowledgment as a response to multiple separate 837 transactions (separate ST/SE envelopes)?
This question is about Loop 2100B (Information Receiver Name) Segment NM1 TR3 Note 3 regarding the situation where there is more than one clearinghouse involved in the transmission. For the second hop in the r...
For the 005010X279 TR3 Section 1.4.8.1 (Required Primary Search Options), could you please clarify the meaning of "patient is in their database" in terms of case sensitivity? Assume that both trading partners support the Extended Character Set. The information sour...
In the 835 guide (Section 1.10.2.13), it states that the "impact" of the primary (prior) payer's adjudication should be reported in a CAS segment with OA 23. The "impact" is described as "up to the actual amount of the primary payment(s) plus contractual adju...
What is the appropriate Claim Adjustment Reason Code (CARC) that Medicare Supplement Plans should use on their 835s for lines that are adjusted by the primary (Medicare) because Medicare is bundling/packaging the service into the primary Ambulatory Payment...