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Back  RFI # 535: Account Number in 835

Formal vs. Informal Help Informal Formal

Submitter

Bob Resh

Description

If I do not regularly key the account number from a paper claim into my adjudication system, is there any requirement to do so when a provider is requesting an 835 for population of CLP01 or can I continue to not key account numbers from paper claims? If there is a requirement, how many characters must be supported for the paper claim account number, since the size limit to 20 is in the 837?

Response

CLP01 is the identifier used to track a claim from creation by the health care provider through payment. It is the value assigned by the provider so that they track a payment record back to the patient in their account receivable system. This is one of the key elements needed for auto-posting.

It is required that the payer returns the patient account number, as submitted, on the claim regardless of the media used by the provider for submission. Therefore it is a required data element from a paper claim. If the patient account number is missing from a claim, then, and only then can a zero value be returned in CLP01.

The patient account number is alpha-numeric and ranges in size from 1 to 38.

Recommendation

If the payer’s system cannot accommodate a patient account number greater than 20, recommend including field length in the trading partner agreement.
Submission 3/21/2007
Status Date 6/18/2007
Status F - Final
Primary References
Document 004010x091A1
Section3
Page89
Set ID835
Table2
Loop2100
Segment Position010
Segment IDCLP
Element Position01
Industry NameClaim Submitter's Identifier