The policy number in the insurance tab of patient demographics is currently restricted to 0-9 and A-Z. In particular, dash ‘-’ is not permitted. What’s the logic behind this? The client we are working with requires ‘-’ to be permissible especially for cases where the same policy number is used for self, spouse, and children, the only difference being self’s policy number ends with “-00”, spouse’s number ends with “-01”, and children’s number ends with “-02”. I can imagine other case where it would be desirable to include dashes. Also HCFA 1500 doesn’t seem to have any restrictions with dashes in insured’s ID number in field 1A. So why do we currently have this restriction?
Speaking from my experience with electronic claim processing (10+ years), this is a valid and necessary scrub when dealing with patient/subscriber ID numbers in the electronic claim world, specifically in the 837 claim file in the 2010AB Loop, Field NM109. Generally speaking, in EDI processing, the payer claim processing/adjudication system would have 12345678901 and 12345678902 in their subscriber files, even though the card may reflect 123456789-01 and 123456789-02. We, as a clearinghouse, also maintain that scrub in our processing system.
It can be a hard sell to the front-desk staff when they see one number, but enter another and “they’ve always been paid that way on paper”, but it is certainly to their advantage to get their data entered in an acceptable EDI manner from the beginning because sooner or later they will have to, otherwise their claims will reject once they do begin to process electronically.