Will encounters from the same billing provider be grouped together?


When the plan submits their ANSI ASC X12 837 Health Care Claims (837) to Palmetto GBA it must conform to the standards as outlined in the Technical Report - Type 3 (TR3). This standard employs a hierarchical data structure, which allows for relating many encounters to one billing provider. The Billing Provider Hierarchical Level is a required segment and is identified in the 2000A Loop of the 837. The grouping of encounters to the billing provider will be done by the MMPs.

Last Updated: 04/15/2014