Submitting to Availity for ins. co. Beacon Health I am forced to look up the zip+4 to avoid an automatic “9999” being appended to patients zip code. I have looked and can’t find this in the settings. This is the only ins. co. I have this issue with. Is this hardcoded or a setting? Thank you.
hi @sole_practitioner, that would be an informational error and not something that requires fixing to get the claim submitted.
Its causing file level rejections from a blue cross payer too. They want the real plus 4 in the billing loop and for other zips they want only 5 digits or real plus 4.
I put an edit in place at the clearinghouse i own to remove 9999 or 0000. This avoids the file reject and if a payer requires 9999 or 0000 i can put back in before the claim goes out as a payer edit.
Nothing worse than file level rejections; i pride myself that ClaimRev returns mainly 999 acceptance and rarely a reject.
Ok, I finally located the code that is padding the zip code with nines.
In my opinion, this should be a global under the billing tab. Not all clearing houses want a 9-digit zip code. It would be better if this were a choice to make.
Follow the spec. What does it say?
The specs say if the number is only 5 digits. It will pad the number with 9s. Is that what mean.
If the +4 is added to the zip to make it 9 digits. The 9s will not be added.
As you know, EUs won’t take the time to go find the +4 and the clearing house, office ally, will accept the claim with just 5 digits for the zip code.
Help me to see the light @sjpadgett.
I did say it was my opinion. =^)
I guess if you have to support it I’d put it in the x12 partner not globals.
The spec says a full 9 digit zip code must be used for loops 2010AA, 2310C, and 2420C. It must be the true 9 digit zip code though. Payers are rejecting at the file level (999 reject) for 0000/9999.
As for other places, the spec is ok with 5 digit or 9 digit. It just has to be not fake data.