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Back  RFI # 1159: 835 service/rendering provider

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Submitter

faye ostroot

Description

The 5010 835 has the situational rule for the service provider segment in the 2100 loop as: Required when the rendering provider is different from the payee. Does the 'rendering' provider refer only to the values submitted as the rendering provider loops in the 837 or is it more general like the 276/277 where the service provider is either the billing or the rendering The examples at the 5010 835 TR3 have the rendering segment populated with both the organization name and the individual name.

Response

The intent of the work group was to supply at this claim level the provider who rendered the service if different then the payee. This would be relational to the rendering provider in the 837 and can be an organization or an individual.

The Service Provider in the 835 should be the Rendering Provider, if the Rendering Provider is present in the claim.
Submission 9/24/2010
Status Date 2/7/2011
Status F - Final
Primary References
Document 005010X221
Section2.4
Page146
Set IDNM1