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Certification
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Resolution: Answered
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Moderate
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None
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Submit both primary payers using the Patient Characteristic Payer template, and each instance will have different effectiveTime/low and high to reflect the payer’s effective time.
If an encounter is found to have 2 primary payers effective at one point of the visit, we are looking for guidance on which Payer information should be included in the QRDA I file. Could either payer be included? Thanks
Example:
Encounter begin on 3/1/2020 – discharged on 3/10/2020
Payer #1 effective date 1/1/2020 – end effective date 3/5/2020
Payer #2 effective 3/6/2020 – end effective date 12/31/2020