In reviewing the COB white paper today on the business issue call, an issue
came up that I wanted to see if any of you had thought about this.. or.. if
you are on an X12 workgroup.. had they thought about this. The issue is that
if a claim has more than one line. Line 1 may be paid out as Primary and
Secondary while line to may only have a Primary Payer. One example of when
this is common is when line one has a date range and during that date two
insurance companies have coverage but the other lines have dates when there is
only a single payer.
The way to resolve this is to add information to the line level that allows
payers to respond how they paid or split the claim into multiple claims. One
claim would show line one and the other claim would have the other lines for
that claim
Thanks!
Jonathan Showalter
Omaha NE USA
402-343-3381
[EMAIL PROTECTED]
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