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Back  RFI # 427: 835 Periodic Interim Payments

Formal vs. Informal Help Informal Formal

Submitter

chip dycio

Description

Please describe in detail how Periodic Interim Payments (PIP) should be reported on the 835 remittance transaction. Specifically, how should data on the CLP, CAS, PLB, and BPR segments be valued?

Submitter Assigned Keywords

periodic interim payment PIP

Response

Periodic Interim Payments (PIP) instructions are not addressed explicitly in guide 004010X091 beyond inclusion of Adjustment Reason Code PI (Periodic Interim Payment) in the PLB segment. See the detailed instructions in guide 005010X221, section 1.10.2.5 Advance Payments and Reconciliation, for explicit instructions. Those instructions are content compatible with guide 004010X091.

Recommendation

PIP payments are made in the PLB segment using an Adjustment Reason Code of PI, an appropriate identifier and a negative dollar amount. For recoupment/allocation of the PIP amount, the CLP and CAS are used to provide normal adjudication details, including payment amount before PIP. The PLB is again used with the Adjustment Reason of PI, the same identifier and a positive dollar amount for the payment amounts in this 835 that are not being paid due to the previous PIP payment. The BPR segment must always contain a BPR02 value that balances with the rest of the 835.
Submission 7/18/2006
Status Date 9/22/2006
Status F - Final
Primary References
Document 004010X091A1
Sectionn/a
Pagen/a
Set ID835