tion 23, is the claim filing indicator. This indicates if the claim is primary, secondary, etc. This is important so the carrier knows how much they are to be paying. Most primaries pay 80% and most secondaries pay the remaining 20%.

DA0 field 5, position 24, is the payment source. This tells the carrier where the payment is supposed to be coming from. Again, you would think they would know this, but it is to assure that the right carrier gets the right claim.

DA

When doing medical billing, a lot of information needs to be transmitted. So far in this series we have covered information that identifies the provider of services and the patient. Now, we have to cover information that identifies the insurance carrier the claim is actually going to. While this may seem unnecessary, since the person receiving the claims knows who they are, this is actually a safeguard to make sure that claims don't get sent to the wrong insurance carrier. The record that sends this information is the DA0 record. We'll begin going over the specifications for that record in this review.

DA0 field 1, positions 1 - 3, is the record type. This needs to be filled in with DA0 or the claim will be denied.

DA0 field 2, positions 4 - 5, is the sequence number. This requires a little explaining and also clarifies why this record needs to go at all.

When medical billing a claim to an insurance carrier, whether it be Blue Cross, Medicare, Medicaid, or some private insurance, many patients have more the one type of coverage. Some have Medicare and Medicaid. Others have Blue Cross and a private insurance like Prudential. In these cases, especially in the cases of Medicare which usually only covers 80% of the costs, multiple insurance carriers are billed. To do this, you need to send multiple DA0 records. The sequence numbers, 01, 02, etc., designate the number of the insurance carrier being billed, such as the primary, secondary or tertiary. You can have up to three DA0 records for each claim, designated DA0-01, DA0-02 and DA0-03.

DA0 field 3, positions 6 - 22, is the patient ID number. This is the number that identifies the patient and must match the number transmitted in the CA records, both CA0 and CA1, as well as the CB records if they are sent as well. Notice the positions are all the same. This makes it easier to check for accuracy.

DA0 field 4, position 23, is the claim filing indicator. This indicates if the claim is primary, secondary, etc. This is important so the carrier knows how much they are to be paying. Most primaries pay 80% and most secondaries pay the remaining 20%.

DA0 field 5, position 24, is the payment source. This tells the carrier where the payment is supposed to be coming from. Again, you would think they would know this, but it is to assure that the right carrier gets the right claim.

DA0

e record that sends this information is the DA0 record. We'll begin going over the specifications for that record in this review.

DA0 field 1, positions 1 - 3, is the record type. This needs to be filled in with DA0 or the claim will be denied.

DA0 field 2, positions 4 - 5, is the sequence number. This requires a little explaining and also clarifies why this record needs to go at all.

When medical billing a claim to an insurance carrier, whether it be Blue Cross, Medicare, Medicaid, or some private insurance, many patients have more the one type of coverage. Some have Medicare and Medicaid. Others have Blue Cross and a private insurance like Prudential. In these cases, especially in the cases of Medicare which usually only covers 80% of the costs, multiple insurance carriers are billed. To do this, you need to send multiple DA0 records. The sequence numbers, 01, 02, etc., designate the number of the insurance carrier being billed, such as the primary, secondary or tertiary. You can have up to three DA0 records for each claim, designated DA0-01, DA0-02 and DA0-03.

DA0 field 3, positions 6 - 22, is the patient ID number. This is the number that identifies the patient and must match the number transmitted in the CA records, both CA0 and CA1, as well as the CB records if they are sent as well. Notice the positions are all the same. This makes it easier to check for accuracy.

DA0 field 4, position 23, is the claim filing indicator. This indicates if the claim is primary, secondary, etc. This is important so the carrier knows how much they are to be paying. Most primaries pay 80% and most secondaries pay the remaining 20%.

DA0 field 5, position 24, is the payment source. This tells the carrier where the payment is supposed to be coming from. Again, you would think they would know this, but it is to assure that the right carrier gets the right claim.

DA

oss, Medicare, Medicaid, or some private insurance, many patients have more the one type of coverage. Some have Medicare and Medicaid. Others have Blue Cross and a private insurance like Prudential. In these cases, especially in the cases of Medicare which usually only covers 80% of the costs, multiple insurance carriers are billed. To do this, you need to send multiple DA0 records. The sequence numbers, 01, 02, etc., designate the number of the insurance carrier being billed, such as the primary, secondary or tertiary. You can have up to three DA0 records for each claim, designated DA0-01, DA0-02 and DA0-03.

DA0 field 3, positions 6 - 22, is the patient ID number. This is the number that identifies the patient and must match the number transmitted in the CA records, both CA0 and CA1, as well as the CB records if they are sent as well. Notice the positions are all the same. This makes it easier to check for accuracy.

DA0 field 4, position 23, is the claim filing indicator. This indicates if the claim is primary, secondary, etc. This is important so the carrier knows how much they are to be paying. Most primaries pay 80% and most secondaries pay the remaining 20%.

DA0 field 5, position 24, is the payment source. This tells the carrier where the payment is supposed to be coming from. Again, you would think they would know this, but it is to assure that the right carrier gets the right claim.

DA

, such as the primary, secondary or tertiary. You can have up to three DA0 records for each claim, designated DA0-01, DA0-02 and DA0-03.

DA0 field 3, positions 6 - 22, is the patient ID number. This is the number that identifies the patient and must match the number transmitted in the CA records, both CA0 and CA1, as well as the CB records if they are sent as well. Notice the positions are all the same. This makes it easier to check for accuracy.

DA0 field 4, position 23, is the claim filing indicator. This indicates if the claim is primary, secondary, etc. This is important so the carrier knows how much they are to be paying. Most primaries pay 80% and most secondaries pay the remaining 20%.

DA0 field 5, position 24, is the payment source. This tells the carrier where the payment is supposed to be coming from. Again, you would think they would know this, but it is to assure that the right carrier gets the right claim.

DA

tion 23, is the claim filing indicator. This indicates if the claim is primary, secondary, etc. This is important so the carrier knows how much they are to be paying. Most primaries pay 80% and most secondaries pay the remaining 20%.

DA0 field 5, position 24, is the payment source. This tells the carrier where the payment is supposed to be coming from. Again, you would think they would know this, but it is to assure that the right carrier gets the right claim.

DA0 field 6, positions 25 - 26, is the insurance type code. This is a code that the software usually gets from a lookup table in the program that identifies what type of insurance the patient has.

DA0 field 7, positions 27 - 31, is the National Payer Organization ID number. This is a number that is assigned to every payer in the country. This number must match the actual payer you're billing or the claim won't be paid.

In the next article in this series, we'll continue with DA0 field number 8.