DecisionHealth, DecisionHealth - 2009 Issue 11 (November)

CARC changes will direct you to payer websites after 5010 switch

A new addition to a series of claim adjustment reason codes (CARCs) will save you the time and trouble of writing a letter or calling your carrier for clarification. Next April, you'll start to see certain CARCs with the phrase "Note: Refer to the 835 Healthcare Policy Identification Segment, if present" on electronic remittance advices (see chart in full story). The language means you will be able to see a number in the healthcare policy identification segment that you can then use to find the policy on the payer's website once the new 5010 standard is implemented for HIPAA-compliant electronic transfers of claims data.

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