April | 2011
The 835 electronic remittance transaction has enormous potential to save administrative costs for both Payers and Providers. However, problems with the 4010A1 version have prevented providers from realizing the potential cost savings that could be made available through the automated posting of the remittance information.
Problems commonly reported by providers include:
So what, if any, changes have been made in the 5010 to mitigate these issues? It has been noted that the 5010 version of the 835 contains relatively few syntactical differences, but the addition of a critical new data element combined with some substantive Front Matter changes may offer providers the help they are looking for.
Key data change:
The addition of service line ID number (2110 REF*6R) - This is the Line Item Control Number submitted in the 837, and it is now required when sent in the original 837 or when claim or service line splitting has occurred.
New front matter directives:
It remains to be seen if these Front matter changes will be rigorously enforced in version 5010. If not, they may ultimately provide little or no help to providers trying to realize the advantages of "Administrative Simplification."
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