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Back  RFI # 1171: Use of Repricer Received Date

Formal vs. Informal Help Informal Formal

Submitter

Donald Graves

Description

The segment's title suggests a broader usage than just for repricers. Any external entity that does processing on a claim prior to forwarding it on to the destination payer should have a date field in which the entity can register the date it originally received the claim. In particular, we (a payer) send hard copy claims to a third party who scans the claim and generates an 837 which is sent back to us for adjudication. The date the third party received the claim should be the date used to start the claim age clock ticking. The third party we use for this purpose is not a repricer. Other than this Repricer Received Date, I can find no other claim-oriented date segment that could be used to accurately report the date that the claim was originally received by the third pary. Can I utilize this date segment to have the third pary report the date they received the claim even though the third party is not a repricer? If not, can the usage of this segment be broadened in scope in a future version?

Submitter Assigned Keywords

Repricer Received Date

Response

The business scenario of a generic third party claim receipt date is not specifically accommodated in the 5010 837 Implementation Guides.

Recommendation

The issue you describe appears to be related to managing your workflows. It would appear that “claim age clock” should begin when you as the payer receive the paper copy. However, if you feel this is a business need you would like addressed in a future version of the 837 Implementation Guides a formal Change Request should be submitted to the Work Group for consideration.
Submission 10/6/2010
Status Date 11/19/2010
Status F - Final
Primary References
Document 005010X222
Section2
Page181
Set ID837P
Table2
Loop2300
Segment Position1350
Segment IDDTP
Industry NameRepricer Received Date