Section title: Requests for Interpretation
RFI #
952
Eligibility 270 Date
Description

We are receiving a AAA57 rejection on all our 270 requests for a specific payer. This payer is indicating the reason is that we are using a code qualifier 472. They require the code qualifier of 307.

Is a AAA57 the appropriate action? A valid date has been sent. Can a payer reject a transaction with a valid date and valid 472 code qualifier?

RFI Response

Use of AAA03 Code 57 Invalid/Missing Date(s) of Service to reject a transaction when the 270 contained DTP01 = 472 (Date of Service) is not compliant with the requirements of the 004010X092 or 005010X279 guidelines