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Back  RFI # 1054: 5010 DTM Claim Received Date

Formal vs. Informal Help Informal Formal

Submitter

Dora Lambert

Description

In the 5010 TR3 there is a new DTM segment referred to as Claim Received Date. The situational rule indicates it is a required segment when state or federal regulations or the provider contract mandate interest payments or prompt payment discounts based on the receipt date of the claim by the payer. In the DTM02 data element, the note indicates that this data element is the date that the claim was received by the payer.

While AZ Medicaid has such a regulation, it is not based on the receipt date of the claim but rather a clean claim date. The providers may have to provide additional information before the clean claim date can be established; therefore, the receipt date and clean claim date can be two different dates. How would you suggest using this new segment when the dates are different?

Submitter Assigned Keywords

DTM02

Response

While the separate iteration of the DTM segment for the Claim Received Date is new, the usage is not new. Version 4010 included the same DTM01 qualifier as part of the Claim Date DTM segment. The usage of the segment is explicitly for the date that the claim was received by the payer. There is no support for the date that the claim is considered to be clean by the payer.
Submission 5/21/2010
Status Date 11/15/2010
Status F - Final
Primary References
Document 005010X221
Section2.4
Page177
Set ID835
Table2
Loop2100
Segment Position0500
Segment IDDTM
Element Position02
Industry NameClaim Received Date