Change Request Detail
No.
1127
Date
1/27/2011
Submitter
Type of Request
Payment of a Health Care Claim
Status
DSMO Process Completed
Business Reason
Clearly and explicitly report the adjudicated patient name when it is different from the submitted patient name.
Suggestion
Add patient entity identifier code to allow patient corrected name, not just the insured corrected name.
DSMO Category
B
Recommendation
Approve. The DSMO recommends that X12 will define the technical solution for inclusion in a future version.  If X12 makes this a mandatory requirement, the DSMO requests that it be made situational with pharmacy being excluded.
Appeal Recommendation