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Back  RFI # 690: Clarification of 997 for 835's

Formal vs. Informal Help Informal Formal

Submitter

Janet Van Barriger

Description

We have a payor telling us we are not sending the correct information in our 997 GS01 segment for 835 transactions. We are sending 'HP' in that segment when we return the 997 to them. The payer is telling us we should be returning 'FA' in that segment. Can you please clarify for us which is correct? The Implementation Guide is not clear on this. We have not heard of this issue from any other payer that receive our 997's.

Submitter Assigned Keywords

GS01 Segment

Response

Ths issue is explicitly addressed in guide 004010X091.
Page B.15 states that for the 997 the Functional Group ID is "FA". This is the value that must be used in GS01 to identify the transaction types within that specific Functional Group. FA indicates that the Functional Group contains 997s. HP indicates that a Functional Group contains 835s. Usage of HP in a GS01 containing 997s is incorrect. Usage of FA in a Functional Group containing 997s is correct, independent of the type of transaction being acknowledged.
Submission 9/25/2008
Status Date 10/22/2008
Status F - Final
Primary References
Document 004010X091A1
SectionB
PageB.15
Set IDGS01
LoopHeader
Segment PositionGS01
Segment IDGS
Element Position01
Industry NameFunctional Identifier Code
External Code ListHP
Secondary References
RFI ID 621
Document 004010X091A1
SectionB
PageB.8
Set IDGS01