Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.3.1

Outbound File Compliance Check

Last amended: 2013Year: 2013Length: 116 wordsOfficial source
50.3.3.1 - Outbound File Compliance Check (Rev. 2803, Issued: 10-28-13, Effective: 09-17-13, Implementation: 09-17-13) The ASC X12 999 implementation acknowledgment, the ASC X12 835 remittance advice, ASC X12 276/277 claim status response and the ASC X12 277CA claim acknowledgment outbound files shall be compliance checked for the following: • Basic syntactical integrity and specific syntax requirements on all outbound files; • Balanced field totals, financial balancing of claims or remittance advices, and balancing of summary fields, if appropriate for all outbound file; • Specific inter-segment situations described in the HIPAA Implementation Guides for all outbound files; and • Valid TR3 specific code set values and other code sets adopted as HIPAA standards for all outbound files.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.3.1: Outbound File Compliance Check | Justis AI