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Back  RFI # 1114: 835 PLB Reference ID's

Formal vs. Informal Help Informal Formal

Submitter

Jan Klimper

Description

May we send additional reference ID's in the PLB03-2 when using the WO, FB and 72 qualifier? For instance, if we are returning a check number as a reference ID with the FB qualifier, may we also include the patient account number in the reference ID field?

Submitter Assigned Keywords

835 PLB

Response

In the Front matter sections of the 835 5010 TR3, there are sections where specific instruction is given for the reference Ids for a given business scenario. Section 1.2.10 also states “Creation of 835 transactions that are not consistent with the information here is prohibited under this implementation.” When there is very specific statement in the front matter on PLB03-02 content, deviation from that is not compliant.

Recommendation

For example, section 1.2.10.12 states for initiating a Forwarding Balance “The reference number in PLB03-2 will contain the same number as the trace number used in TRN02 of the current transaction. This reference number will facilitate tracking by the provider.” And, “The value in BPR02 will be 0.” Therefore, there will be no check number with a forwarding balance and sending a check number or check number and patient account number is not compliant with the guide instructions. Only the value in TRN02 may be used in PLB03-02 for initiating a forwarding balance.
Submission 7/27/2010
Status Date 2/7/2011
Status F - Final
Primary References
Document 005010X221
SectionAdjstmt
Page218
Set IDPLB