One of the confusing parts of medical billing and electronic transmission of information is the lot. Biller, most do not understand why you even have multiple batches. Can not all the claims just go inside and get a package shipped? Now, with paper, yes. But if you have a large house payroll and billing for a number of suppliers, then the process is not so simple. Before going into our detailed review of YA0 record, a statement of charges is probably in order.

Due to the nature of the claims are paid, especially by the big insurance companies or authorities in the prosecution of batches is very important. Why? Because if insurance companies cut their checks for the claims, they are cut and sent to the provider, not to the patient, unless to do so. If a large settlement house for many providers, they can be very good, a large file, the claim that several suppliers. These vendors are in BA0 in area 2, Position 4-18, the vendor ID. This entry indicates the beginning of the lot and this means the provider associated with this batch. If the biller service provider wants to bill a second, then another recording BA0 must be used, so that the insurers know who is the second carrier. Otherwise, the exam at the end get to a manufacturer. This can of course be a lot of problems.

To ensure that this is not the case, most of the electronic billing software has what is an option, several suppliers. What happens is that somewhere in the system a list of providers in a large table. In very large accounting firms, this table can be hundreds of vendors. Each will receive an ID number and a table. The ID number is assigned by the Governing Agency. The table is supported by the software. Each patient in the system to a provider. Patients claim that the file is withdrawn, a game between the number of the provider, in the patient file and the number of providers. If the provider number is different from the previous series of providers who billed a new BA0 record. Before this happens, but the YA0 is created to the sum of the previous game for the first manufacturer.

This is of course greatly simplified, but hopefully you have the general idea. Once the record YA0 created and filled in and the new BA0 record is created, your multiple-batch system has just entered into force. You simply repeat this process for all providers. The hard part for biller is to ensure that the provider table ID is entered correctly for each patient. Otherwise, the wrong providers for the services provided.

In our next installment of medical billing and electronic transmission of information with NSF 3 / 01 specifications, we will for the YA0 in detail.

Michael Russell

Your independent guide to Medical Billing