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Back  RFI # 1992: Balancing in 277CA

Formal vs. Informal Help Informal Formal

Submitter

Christopher Gracon

Description

Looking in the 005010X214 TR3, I do not see any mention of balancing within the 277CA. But there are the QTY and AMT segments and the STC04 in Loop 2200B which contain totals for all claims being acknowledged (STC04), total claims accepted/rejected (QTY) and total amount accepted/rejected (AMT). With these being totals, is there an implied balancing requirement such that the total claims accepted + rejected (since these are the only 2 options) needs to equal the total number of claims in the 277CA? The same question for the claim total amounts.

Submitter Assigned Keywords

277CA Balancing

Response

The Claim Acknowledgment (277CA) 005010X214 TR3 does not specifically address balancing between the Loop 2200B STC04 (Total Submitted Charges for Unit of Work) and the 2200B AMT (Total Accepted/Rejected Amount) Segments nor does it address a specific balancing requirement that the QTY (Total Accepted/Rejected Quantity) Segments must equal the total number of claims reported in the 277CA. The purpose of the Loop 2200B information is to provide cumulative results of the claims contained within the 277CA in relation to the 837 data being acknowledged. See RFI # 1991 for additional clarification on the specific data contained in Loop 2200B.
Submission 11/21/2014
Status Date 2/23/2015
Status F - Final
Primary References
Document 005010X214
Section2
Loop2200B