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What would be the best DTP to use to reflect the redetermination dates in both 005010 and 008060? We are seeing them come through in message segments, and optimally it would be good to have an official way to reflect them, especially in light of the OBBBA...
Does the 837I format have a standardized location to send a facility’s CLIA number?
ScenarioWe are receiving denials from a state Medicaid with the understanding it is due to the CLIA number not being submitted with the claim. While we are familiar with the loops where ...
Can values not listed in the guide under 2110C EB04 be used? I have noted that the element is a three-character maximum, but all the codes listed in the guide are only two characters.
ScenarioIn this sample EB segment, is the EB04 value of “230” allowa...
How would we translate an inpatient copay days segment from the message to the EB segment and/or using the HSD?
ScenarioExample:
EB*B*IND*48****0****Y*Y~
MSG*Inpatient days 1-7 are 375.00 per day and the...
In a 270 inquiry for a dependent, is it a violation to send both Loop 2100C (Subscriber Name) DTP*291 (Plan) and 2100D (Dependent Name) DTP*291? This does not seem to be explicitly prohibited in the situational rule. If this is not a violation, then how s...