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The following table provides additional information on the alternate payer transaction options.
| Field | Description |
|---|---|
| ERA Payer Numbers | The system checks the payer number in the ERA Payer Numbers field and the GS02 segment of the ERA file. If the payer number matches, then the payments are posted against the alternate payer. In the 835 IG, the ERA payer number can be located in the GS02 segment. |
| Require both payments before settling | If you select the Require both payments before settling check box, and the billing status shows up as waiting for another payment, then the default status on the line item is set to None to prevent further billing until you receive both the payments. |
| Default Reason Code | The default reason code exists at the line item level, and not at the transaction level. Therefore, when posting payments, the default reason code for the alternate payer will be applied to the line item. |
| ERA Reason Code Library | You must use the Reason Codes library when the payer number in the ERA file matches with the ERA payer number of the alternate payer. When you do not select the Reason Codes library for the alternate payer, the alternate payer will use the Reason Codes library of the payer. |
| Remittance Profile Library | When you do not select the Remittance Profile library for the alternate payer, the alternate payer will use the Remittance Profile library of the payer. |
| Default Payment | This is the third-party payment transaction code for the alternate payer. By default, this code appears in the Pay Code field on the Payment Entry window for manual and ERA payments received from the alternate payer. When you do not select a Default Payment code for the alternate payer, the alternate payer will use the Default Payment code of the payer for payments. |
| Default Adjustment | This is the third-party adjustment transaction code for the alternate payer. By default, this code appears in the Adj Code field on the Payment Entry window for manual and ERA adjustments received from the alternate payer. When you do not select a Default Adjustmentcode for the alternate payer, the alternate payer will use the Default Adjustment code of the payer for adjustments. |
| Default Payment for Bad Debt | This is the third-party bad debt payment transaction code for the alternate payer. By default, this code appears in the Pay Code field on the Payment Entry window for manual and ERA payments received from the alternate payer on encounters in the Bad Debt status.
When you do not select the Default Payment for Bad Debt code for the alternate payer, the alternate payer will use the Default Payment for Bad Debt code of the payer for payments on bad debt encounters. |
| Default Adjustment for Bad Debt | This is the third-party bad debt adjustment transaction code for the alternate payer. By default, this code appears in the Adj Code field on the Payment Entry window for manual and ERA adjustments received from the alternate payer on encounters in the Bad Debt status.
When you do not select the Default Adjustment for Bad Debt code for the alternate payer, the alternate payer will use the Default Adjustment for Bad Debt code of the payer for adjustments on bad debt encounters. |
| Reversals/Corrections Payment | This is the third-party payment transaction code for the alternate payer. By default, this code appears in the Pay Code field on the Payment Entry window for the ERA reversal and correction payments received from the alternate payer in the 835 file with a claim status of 22. When you do not select a Reversals/Corrections Payment code for the alternate payer and the Remittance Profile library is setup to allow posting of reversal/correction payments, the alternate payer will use the Reversals/Corrections Payment code of the payer for the ERA reversal/correction payments. |
| Reversals/Corrections Adjustment | This is the third-party adjustment transaction code for the alternate payer. By default, this code appears in the Adj Code field on the Payment Entry window for the ERA reversal and correction adjustments received from the alternate payer in the 835 file with a claim status of 22. When you do not select a Reversals/Corrections Adjustment code for the alternate payer and the Remittance Profile library is setup to allow posting of reversal/correction adjustments, the alternate payer will use the Reversals/Corrections Adjustment code of the main payer for the ERA reversal/correction adjustments. |