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Back  RFI # 1581: BPR Informational Only

Formal vs. Informal Help Informal Formal

Submitter

Gladys Jones

Description

Is it compliant to have a BPR01 = H, a BPR04 = NON and a BPR02 greater than zero. The guide does not specifically say that BPR02 must be zero when BPR01 is H.

We have a need to allow the BPR, informational only (BPR01 = H with BPR03 = NON) to contain the total claim payment amounts added together.

Submitter Assigned Keywords

BPR BPR01 BPR04

Response

Per the explicit rules of the TR3, it is not permissable to have a combination of BPR02 = greater then zero dollars / BPR01 = H / BPR04 = NON. For BPR01 value of 'H' (Notification Only) the guide states, "Use this code when the actual provider payment (BPR02) is zero and the transaction is not being used for Prenotification of Future Transfers. This indicates remittance information without any associated payment."

Recommendation

The work group recommends that you consult with your vendor to ensure that the TR3 balancing rules are being followed. This will prove the amount in the PLB equals the amount that is moving forward.
Submission 5/1/2012
Status Date 6/29/2012
Status F - Final
Primary References
Document 005010X221
Section2.3.1
Page69
Set ID835
Table1
LoopHeader
Segment Position0200
Segment IDBPR
Element Position02
Industry NameMonetary Amount