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  1. QRDA Issue Tracker
  2. QRDA-923

Episode of Care with multiple primary Payer

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    • Certification
    • Resolution: Answered
    • Moderate
    • None
    • 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.

    Description

      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  

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            matthew.tiller Matthew Tiller
            isbelia Isbelia Briceno
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              Updated:
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