Change Request Detail
No.
1143
Date
2/4/2011
Submitter
Type of Request
Payment of a Health Care Claim
Status
DSMO Process Completed
Business Reason
More efficient processing of 835 files
Suggestion
1.     PLB segments need to be more descriptive.  Currently, lettered codes are being used to identify adjustments but, those do not provide any information as to where or what patient it should be applied to.

2.    Within the PLB CS adjustment information, we would like to have Date of Service added.  Currently, we only get the patientís medicare number.

3.    We would like to have the 835 files split by NPI for easier processing.  Currently, they come all in one file.
DSMO Category
B
Recommendation
Approve.The DSMO recommend the submitter works with X12 Claims Payment (835) Workgroup for solutions to a future version.

Appeal Recommendation