EDI Training Day 3

EDI Training Day - 3

Transfer Claim from Denormalized table to Normalized table

X12_837_claim_professional

Mup_Transfer4m_X12ToMtabTables

Mtab_x12_837_Claims

Mtab_x12_837_Services

CST01

CST 99

EDI

Claim Submitter Services

Quickcap 7

Fill The Claim Object and Send

Generate The Claims

Apply Level 2 Validation

EDI CLaim Id Portal ClaimNo Errors

254606 2015041083700819

NULL

254607 2015041083700820

NULL

254608 NULL Provider ID not found or empty

254608 NULL Member ID not found or empty

Response

Mtab_X12_837_Claim_Errors

Possible Level2 Rejections

1) Member ID not found or empty.2) Invalid Organization3) Provider ID not found or empty.4) Invalid Provider Vendor Association5) Invalid Diagnosis Code.6) Claim Diagnosis 4 should only be used after using Diagnosis 3, Diagnosis 2 and Diagnosis 1.7) Invalid diagnosis reference number.8) Received Date should not be greater than Today's Date9) Received Date should not be blank

10) Invalid Place of Service11) Admission Date is required for Place of Service 21 - INPATIENT HOSPITAL.12) Ambulance information is required.13) Service code not found or empty.14) Invalid NDC Code.15) Service Line [1] Service code 1 not found or empty.16) Service Line [1] Modifier code 1 not found or empty.

DCN: RHNM150970012013

Claim Type Claim Year JulianDay BatchNo Calim in Batch

Thank you