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Back  RFI # 2214: NY NoFault Remit Data

Formal vs. Informal Help Informal Formal

Submitter

Chip Evelsizer

Description

The state of New York is considering future electronic healthcare data exchange mandates for No Fault insurance. The current paper based rules require some data related to remittance (see NF10) to be exchanged that may not be supported in the 5010 835 transactions. State mandated data values not currently supported in the TR3s are typically accommodated on a case by case basis but no specific segment is reserved for this purpose (as opposed to the 837 TR3s which use the K3 segment).

Examples of NY specific data values include: Date of accident, Payer Assigned Claim (Event) Attorney’s Fee, Death Benefit, Date final verification requested, Date final verification received…

What method would X12 recommend to send all of the New York required data values that are not currently supported in the 5010 TR3 for voluntary exchanges prior to an electronic mandate? Would that method change if and when the data requirements are mandated by law to be sent electronically?

Submitter Assigned Keywords

NF10 NoFault REG68 Property Casualty

Response

The 835 doesn’t have a way to accommodate unplanned data elements.

Recommendation

If you have a business need not supported in a published TR3, you may submit an X12 change request for consideration in a future version beyond 7030 of the TR3. Change requests are submitted at http://changerequest.x12.org/.
Submission 5/16/2017
Status Date 7/19/2017
Status F - Final
Primary References
Document 005010X221A1
Section2.4