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Back  RFI # 1392: Claim Received Date Rule

Formal vs. Informal Help Informal Formal

Submitter

stacey alsdurf

Description

The Situational Rule says "Required whenever state or federal regulations or the provider contract mandate interest payment or prompt payment discounts based upon the receipt date of the claim by the payer. If not required by this implementaion guide, may be provded at sender's discretion, but cannot be required by the receiver."

My interpretation of this rule is that this segment would be sent for every claim if a state law (or federal regulation) mandates interest payment based upon receipt date of the claim. Is that correct?

Another interpretation within my company is that this segment would only be sent for claims where interest is being paid. Is that correct?

Submitter Assigned Keywords

claim received date, prompt pay, interest

Response

This issue is explicitly addressed in guide 005010X221A1. The situational rule states "Required whenever state or federal regulations or the provider contract mandate interest payment or prompt payment discounts based upon the receipt date of the claim by the payer...". This does not state that interest must be payable. It only states that a mandate exists for paying of interest based upon the date of receipt of the claim. Therefore, when there is a mandate to pay interest that is based upon when a claim is received, the receipt date for the claim must be reported on all claims, independent of whether or not interest is actually paid on a specific claim.
Submission 8/30/2011
Status Date 10/17/2011
Status F - Final
Primary References
Document 005010X221
Section2.4
Page177
Set ID835
Table2
Loop2100
Segment Position177
Segment IDDTM