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Back  RFI # 1334: Clarification on AMT A8

Formal vs. Informal Help Informal Formal

Submitter

Holly George

Description

Can you advise what the purpose of the AMT*A8 is? Is this used when you are billing the primary or the secondary payer when it states the value is to equal the CLM02?

The interpretational portal had one question on the AMT*A8 (RFI 1006)but the response was merely the same information contained in the TR3.

Submitter Assigned Keywords

Clarification on AMT A8

Response

The total non-covered amount segment is required when the destination payer's cost avoidance policy allows providers to bypass claim submission to the otherwise prior payer identified in Loop - 2330B. It is used when the prior payer is not billed because the destination payer's policy allows providers to submit the claim without the prior payer's adjudication information. This only applies when there is no 835 or paper remittance from the prior payer.
Submission 6/15/2011
Status Date 8/19/2011
Status F - Final
Primary References
Document 005010X222
Section2320 AMT
Page306
Loop2320