LOOP 2300 CLIA - Availity Change

infrastructure
question

(Sherwin Gaddis) #1

We have an issue with the clearinghouse and I was wondering has anyone else seen this issue.

All the AARP Medicare Complete patients CPT code 80307 are denying stating that the CLIA is not pulling to the correct place on the form. We submitted a ticket to the clearinghouse on pt acct #2233 date of service 8/29/18. This was not a problem before and it seems to only be affecting AARP MCR Comp so far. Here is RealMed’s (now Availty) answer:

“The following is the resolution to the support ticket that you submitted. ISSUE REPORTED: Please advise on CLIA not pulling to the correct spot SCOPE/IMPACT: 1 claim in status management ROOT CAUSE: Per our review, this claim was sent over in a .5010, not an HCFA. We pulled the inbound file and the CLIA number is not in the correct spot. CORRECTIVE ACTIONS: To fix this claim and to get the CLIA in the correct spot, please work with your PM system to add this number to Loop 2300 Segment REF with an X4 qualifier. Once this is added, you can resubmit the claim for processing.”

I was looking at the gen_x12_837 file. It is the only place that I could find the Loop 23.

@sjpadgett


(Stephen Waite) #2

hi @juggernautsei, what openemr version is generating the claim file?


(Sherwin Gaddis) #3

The version is 5.0.1 no patches


(Stephen Waite) #4

thanks @juggernautsei, looks like you’ll have to change the payer type under admin->practice->ins co to medicare


(Sherwin Gaddis) #5

Thanks, I will let the biller know I have made the correction.

Are you talking about this @stephenwaite ?

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