RFI #
1056
Multiple Denial Reasons
Description
Is there a way to report multiple claim denial reasons (CARC's) for the billed charge amount? Is it possible to split the dollar amount across the claim by the number of denial reasons? If so, how would the provider handle this in their account receivable? Reporting only one CARC per claim (or claim line) prevents the provider from being able to correct all applicable denial or reject reasons prior to resubmission.
RFI Response
There is no way in the 5010 835 to report and/or associate multiple adjustment reason codes with a single dollar amount.
As a result of structural changes to the 835 standard, the developers plan to correct this situation in the next version of the guide.
DOCUMENT ID
005010X221