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Back  RFI # 510: RARCs in 835 reversals

Formal vs. Informal Help Informal Formal

Submitter

Peter Anderson

Description

Are remittance advice remark codes required in reversals?

There is a requirement beginning 4/1/07 for remittance advice remark codes to be used with claim adjustment reason codes 16, 17, 96, and 125. Does this requirement apply to reversals as well as original and corrected payments?

Response

This issue is not explicitly addressed in guide 004010X091. If the original claim payment did not have a Remittance Advice Remark Code (RARC), then the reversal of the claim payment does not need it. It is also true if a RARC was reported on the original claim payment it must be included in the reversed claim.

Recommendation: To facilitate the auto-posting of a reversal in a providers account's receivable system, the workgroup recommends that the original payment be completing reported in the 835 using Claim Status Code 22, Group Code CR, and negative values for all of the previously reported dollars.

Recommendation

To facilitate the auto-posting of a reversal in a providers account's receivable system, the workgroup recommends that the original payment be completely reported in the 835 using Claim Status Code 22, Group Code CR, and negative values for all of the previously reported dollars.
Submission 1/16/2007
Status Date 3/30/2007
Status F - Final
Primary References
Document 004010X091A1
Section2.2.8
Page28
Set ID835