Question 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?

Answer posted on date shown 5/14/2001:

Yes.


Question Would they then follow the rules in the 835 Implementation guide for reporting back split claims?

Answer posted on date shown 5/14/2001:

Yes.


Question Would this be allowable under the HIPAA regulations?

Answer posted on date shown 5/14/2001:

Yes


Question 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?

Answer posted on date shown 5/14/2001:

No, they could forward the split claim.