Section title: Requests for Interpretation
RFI #
1598
Claim Received Date
Description

The Claim Received Date is referenced in several X12 Healthcare transactions, including the 835 in loop 2100 as Claim Date Received and the 277CA in loop 2200A as Information Source Receipt Date. For the 5010 837 Professional transaction, is there any date value contained in the transaction that would be considered the Claim Received Date or is the Received Date the date that the transactions is physically received by the Payer (or the payer authorized agent)? Jurisdictional rules sometimes base Prompt Pay timing rules on the date the claim is received. This request is not related to the case where a repricer is passing the claim onto the payer.

RFI Response

There is no specific date in the submitted 837 transaction that is defined as the Claim Received Date, therefore the Claim Received Date is a date determined by the payer. The date the payer is required to use may be defined in legislation, statutes, or by the contractual requirements of the prompt payment discount.

DOCUMENT ID
005010X222