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Back  RFI # 1926: 005010X214 REFD9 Usage

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Submitter

Chet Manmano

Description

Is a receiver required to return 2200D.REFD9 in the 277CA? Per the TR3 "Required when sent in the 837". If the receiver is not required to return this value, how does the sender associate the claim status to a particular claim?

Submitter Assigned Keywords

005010X214 277CA 2200D

Response

This issue is addressed in the 005010X214. Sending the ‘Claim Identifier for Transmission Intermediaries’ in the 837 (Loop 2300, where REF01=D9) is situational. Therefore, returning that data in the 277CA is dependent on a value FIRST being sent in the 837. If the Claim Identifier for Transmission Intermediaries is sent in the 837 (Loop 2300, where REF01=D9) for a particular claim, then per the 277CA situational rule, that exact identifier MUST be returned in the 277CA (Loop 2200D, where REF01=D9). This identifier is not the primary identifier used for associating the status to the claim within the provider’s billing system.



The primary identifier for associating a 277CA Claim Status to the respective 837 claim data (Loop 2300) is the 2200D TRN - Claim Status Tracking Number (TRN02). The 277CA 2200D TRN02 must carry the exact value as submitted in the CLM01 of the corresponding 837. When the provider assigns a unique value for each CLM01, it creates a distinct and direct link for associating the 277CA claim status with the claim data within the provider’s billing system. Both the CLM01 and 2200D TRN02 are required elements and therefore, their data can reliably be used to associate the claim status to the claim within the provider’s system.
Submission 4/17/2014
Status Date 5/16/2014
Status F - Final
Primary References
Document 005010X214
SectionTable 2
Page86
Set ID277CA
Table2
Loop2200D
Segment Position1100
Segment IDREF
Element Position02