RFI #
2135
CLM05-03 usage
Description
We have a payer that is returning secondary payments as a Status 1 in the CLP-02 in the 835 transactions.
We have contacted the payer and they have no plans to correct this issue. This issue has been going on for 8 months.
Is this allowable per the X221 Guide?
RFI Response
Returning secondary payments with a value of 1 in the 835 claim status code (2100 CLP-02) is not compliant with the 005010X221A1 guide
A value of 1 in the claim status code indicated that the claim was processed as primary. Secondary payments are to be reported with a value of 2.
DOCUMENT ID
005010X221