Section title: Requests for Interpretation
RFI #
1927
Clarification of IK5
Description

Clarification is needed for the use of E (Accepted But Errors Were Noted) in the 2110 - IK501. With the verbiage from the 999 Implementation Guide for the IK5 E indicating “The transaction set indicated in this AK2 loop contained errors, but was forwarded for further processing” does this in fact mean that all claims in the AK2 loop, even the claims with errors were sent on for further processing, and adjudication or does this indicate that only claims without errors are sent on for processing. Submitter Specified Prior Related RFIs Submitter Assigned Keywords IK5 X12N Response: The IK501 code “E” has an industry note of “The transaction set indicated in this AK2 loop contained errors, but was forwarded for further processing.” where the key word is “transaction”. This indicates that the entire contents of the transaction are moved forward to the next step in the receiver’s process, which doesn't necessarily equate to claim(s) adjudication. Subsequent editing processes may reject individual claims within a transaction prior to a claim being adjudicated. Action by a trading partner that receives a non-compliant transaction is discussed in RFI # 1512.

RFI Response

n the 005010X231A1 Technical Report Type 3 (TR3) the IK501 code “E” has an industry note of “The transaction set indicated in this AK2 loop contained errors, but was forwarded for further processing.” This indicates that the entire contents of the transaction set are moved forward to the next step in the receiver’s process, which doesn't necessarily equate to claim(s) adjudication. Subsequent editing processes may reject individual claims within a transaction set prior to a claim being adjudicated. Action by a trading partner that receives a non-compliant transaction set is discussed in RFI # 1512.

DOCUMENT ID
005010X231