Section title: Requests for Interpretation
RFI #
2831
BPR01 and BPR02 Requirements (835)
Description

Please clarify the correct usage of the BPR01 and BPR02 segments in the following situation.

Scenario

Payer contracts with a 3rd party payment vendor to create payments and send 835s.

For a specific group, the payer sends payment data with a check paid amount of $0 indicating the 3rd party should only create the 835 and that they should not create an outbound payment to the provider. The payer's intent in this situation would be to send the payment out directly and the 3rd party vendor would only be responsible for creating the 835. The 3rd party vendor has no control over when the payment is actually sent by the payer to ensure the 72hr rule is upheld.

RFI Response

Please refer to the X12 guide under BPR 01 which gives the exact instructions on the usage of each qualifier. Each code qualifier denotes how the payment and remittance are sent. The payer or their vendor chooses the code that fits their process.

The BPR02 is the total amount of the payment that is being sent to the provider.

The vendor follows the same guidelines that the payer follows if sending these out themselves.

DOCUMENT ID
005010X221A1