COB Electronic Claims Sub-Tab
The options on the COB Electronic Claims tab work only for electronic secondary claims and accommodate 837 COB requirements.
Field | Description |
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Populate 2400 CN1 contractual adjustment segment | Select this option to add a service line CN1 segment (2400). This amount is also referred to as the OTAF (obligated to accept in full) amount. If this option is enabled and a service line contractual adjustment exists (CAS*CO), then the allowed amount is added as the 2400 CN1 amount. The presence of the CAS*CO segment causes the CN1 segment to create mimicking the allowed/approved amount in the AMT*AAE segment. |
Enable COB information popup in payment entry | Select this option so that during transaction entry the Coordination of Benefits Information window automatically displays when the user tabs out of the Reason field for the last transaction detail row. |
Populate 2320 AMT*F2 patient responsibility amount segment (4010 only) | Select this option to add a claim level AMT*F2 segment. If this option is enabled and a service line patient responsible adjustment exists (CAS*PR), then the patient responsibility amount will be added in the 2320 AMT*F2 segment. The presence of the CAS*PR segment causes the AMT*F2 segment to create. This option will be ignored if enabled when creating 5010 electronic secondary claims. |
Populate 2330 DTP*573 claim-level adjudication date | Select this option to populate the claim-level adjudication date Loop 2330, DTP*573 for COB claims. This option is used to send other payers adjudication date at the claim level. It can be used in place of reporting the adjudication date at the service line level. |
Suppress other payer detail line 2430 loop | Select this option to suppress the SVD, CAS, and DTP segments from service line Loop 2430 file types 837P and 837I. This option also suppresses service line Loop 2400 segment AMT*AAE for file type 837P. This option should be used when the COB payer doesn't want the other payer's payment detail reported at the service line level. |
Populate 2320 SBR04 with primary MSP payer ID or name | Select this option to use the electronic claim form for the MSP payer ID or name. |
Populate 2330B NM109 with primary Carrier/TPL Code | Select this option to populate the 2330B NM109 segment with the primary carrier code or the TPL code on secondary electronic claims. This option will default to null on an upgrade. |
Populate 2430 SVD01 with primary Carrier/TPL Code | Select this option to populate the 2430 SVD01 segment with the primary carrier code or the TPL code on secondary electronic claims. This option will default to null on an upgrade. |
Populate 2320 claim level approved/ allowed amounts (4010 only) | Select this option to enable or disable AAE and B6 together or independent of each other at the 2320 claim level. The 837P file type utilizes both AMT*AAE and AMT*B6. Options include:
This option will be ignored if enabled when creating 5010 electronic secondary claims. |
Populate 2320 CAS claim level adjustment amount | Select this option to add claim level (2300) CAS segments if the comparable segment exists at the service line level. These segments are the same for the different file formats (professional or institutional). Only one claim-level CAS segment is allowed per individual group code. The two most common segments are listed below:
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Prevent COB claims from being created until all line items have zero balances from previous payers | Select this option to prevent COB claims from being created unless all line items have payments from a previous payer and the balance is zero. The only exception to this rule is for non-covered payer SIMs defined in the Service Items library on the Payer tab. |
Populate AMT*A8 for prior payer non-covered services | Select this option to send the 2320 AMT*A8 on COB claims when the service is not covered by a prior payer for all claim types in the 5010 and 4010 format. When you enable this option:
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Remaining Patient Liability (AMT*EAF) | Select one of the following options:
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