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Back  RFI # 1203: Rate-up amount on X12 834

Formal vs. Informal Help Informal Formal

Submitter

H Kay White

Description

We have a need to receive a percentage for a rate-up based on pre-existing conditions on X12 834. In looking at the 5010 TR3, the best choice seems to be FK qualifier on 2300 AMT segment, but FK is not valid for 4010. In the interim, we are thinking we could go with P3 qualifier since the amount is related to premium, though not the actual premium amount.



We would appreciate confirmation of this approach or a better suggestion for both 4010 and 5010.

Submitter Assigned Keywords

834 Rate-up factor

Response

WG4 recommends utilizing HD04 for the population of the rate up percentage under 4010.

Recommendation

For 5010, the ASCX12 standards does not allow the AMT02 value to be represented as a percentage. WG4 recommends to utilize the "FK" qualifer in Loop 2300 AMT01, and supply the rate as a dollar amount per $100 dollars. To implement this solution, it must be specified within your Trading Partner Agreement.

For additional modifications to a future guide to meet your business need, WG4 recommends that you draft up a business case and present to the work group at any upcoming Standard Meeting.
Submission 11/18/2010
Status Date 6/2/2011
Status F - Final
Primary References
Document 005010x220
Section2
Page145
Set ID834