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Back  RFI # 2184: Clarification on RFI 2123

Formal vs. Informal Help Informal Formal

Submitter

Julia Dunicheva

Description

RFI 2123 states: PLB/L6 must be the sum of all the AMT*I amounts, with the exception of when the sum is $0.

However example provided in p. 1.10.2.9 has amount with different signs (i.e. positive / negative):
AMT*I*67.81~
PLB*12345*20021231*L6*-67.81~

Is this example correct?
Does it mean that sum of AMT*I amounts should be translated to PLB/L6 amount with the opposite sign (i.e. become negative from positive)?

Response

In the 005010X221A1 guide, section 1.10.2.9 explicitly states “Convey the net for all claims in the remittance advice for interest in the Provider Adjustment Segment using Adjustment Reason code L6.”
In the TR3 Notes for the PLB segment explicitly states “These adjustments can either decrease the payment (a positive number) or increase the payment (a negative number). Zero dollar adjustments are not allowed.
Therefore, the example is correct, the PLB for interest would be the opposite sign of the sum of the amount in AMT*I, because it needs to convey an increase in the payment amount.
Submission 12/9/2016
Status Date 1/24/2017
Status F - Final
Primary References
Document 005010X221
Section1.10.2.9
Page34
Set ID835
Segment IDPLB