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Formal vs. Informal Help Informal Formal


Barber Meg


How to report in current Remit for multiple different FB (different TRN02) from Prior ERA's. Example Day 1 FB created for check A, Day 2 FB created under check 2, day 3 check C we want to pay the provider and try to recoup the Day 1 and 2 money. Situation 1 - we are able to recoup all of day 1 and partial of Day 2, Sitauation 2 - we are able to recoup some from Day 1 and some from day 2 How would the current remits look for each situation:
Situation 1
PLB FB check A +$
PLB FB Check B +$ and FB checkC for -$ still owed.
Situation 2
PLB: FB check A+$ and FB check C for -$ still owed
PLB FB check B +$ and FB check C for -$ still owed
in situation 2 we would show FB twice for check C but with diffefferent balance forward amounts. Reason beging we need to be clear what money is satisfied with what original FB. If we show just one FB for check C with the accumulation of what remains the provider will have no way to track what had been satisfied with the original checks A and B.
Do you agree?


Situation 1 would be allowed, but it wouldn't be ideal.

For Situation 2, Section states "This capability allows a payer to move the negative balance from the current 835 into a future transaction." The emphasis there is on the use of singular terminology - "the negative balance... into a future transaction". As a result, any 835 moves a single negative balance from the current 835 into a future 835. The process doesn't support splitting that into two partial entries as described in situation 2. Situation 2 would create a problem for payers and payees trying to track forwarded balances since it is using the same identifier for two different dollar values.


For situation 1 it would be better to process the 835s in a serial process. Moving FB A into Remit B and then the total FB B into Remit C is the preferred mechanism for handling this situation. You would then have PLB entries like:

Remittance A: PLB*FB:RemitA*-DollarsA

Remittance B: PLB*FB:RemitA*DollarsA*FB:RemitB*-DollarsB

Remittance C: PLB*FB:RemitB*DollarsB*FB:RemitC*-DollarsC
Submission 5/13/2015
Status Date 9/21/2015
Status F - Final
Primary References
Document 005010X221
Segment IDPLB
Industry NameProvider Adjustment
Code ValueFB