If a payer's
adjudication system cannot handle 999 lines for institutional claims or 50
lines for professional and dental claims, can they accept the claim in their
pre-processing system, and then split the claim for processing in their
adjudication system with the number of lines the system can handle?
5/14/2001:
Yes.
Would they
then follow the rules in the 835 Implementation guide for reporting back
split claims?
5/14/2001:
Yes.
Would this be
allowable under the HIPAA regulations?
5/14/2001:
Yes
If the payer
had a COB trading partner agreement, and split the claim for processing in
their adjudication system, would they have to reassemble the original claim,
or could they forward the split claim to the secondary payer?
5/14/2001:
No, they could forward the split claim.