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Back  RFI # 1927: Clarification of IK5

Formal vs. Informal Help Informal Formal

Submitter

Betty Westbrook

Description

Clarification is needed for the use of E (Accepted But Errors Were Noted) in the 2110 - IK501.

With the verbiage from the 999 Implementation Guide for the IK5 E indicating “The transaction set indicated in this AK2 loop contained errors, but was forwarded for further processing” does this in fact mean that all claims in the AK2 loop, even the claims with errors were sent on for further processing, and adjudication or does this indicate that only claims without errors are sent on for processing.

Submitter Assigned Keywords

IK5

Response

In the 005010X231A1 Technical Report Type 3 (TR3) the IK501 code “E” has an industry note of “The transaction set indicated in this AK2 loop contained errors, but was forwarded for further processing.” This indicates that the entire contents of the transaction set are moved forward to the next step in the receiver’s process, which doesn't necessarily equate to claim(s) adjudication. Subsequent editing processes may reject individual claims within a transaction set prior to a claim being adjudicated.

Action by a trading partner that receives a non-compliant transaction set is discussed in RFI # 1512.

Additional information concerning rejection and the acknowledgement reference model is discussed in RFI # 55.
Submission 4/18/2014
Status Date 6/6/2014
Status F - Final
Primary References
Document 005010X231
Section2
Page39
Loop2110
Segment PositionIK501