In our previous installment on medical billing and the electronic transmission of claims, we briefly touched on multiple batches and why they're required when billing. In this installment, we're going to cover the batch trailer record and the individual fields it contains.
The batch trailer record is the YA0 record and comes at the very end of the batch for a provider, immediately after the last XA0 record for the last patient in that batch. If this record falls out of sequence, the whole claim file for that batch will be rejected. In some cases, the carrier will reject all batches in the file.
YA0 field 1, positions 1 - 3, is the record type. This needs to be filled in with YA0 otherwise the batch file will be rejected by the carrier.
YA0 field 2, positions 4 - 18, is the provider ID number. This must be the same provider ID number that is transmitted in the BA0 record in field number 2. If these numbers don't match, the whole batch will be rejected by the carrier.
YA0 field 3, positions 19 - 21, is the batch type. This field tells the carrier what type of batch is being sent. There are only two valid values for this field. The number 100 is transmitted for all batch types except dental. For dental claims, the number 200 is sent. This must also be identical to the number in the BA0 record, field number 3.
YA0 field 4, positions 22 - 25, is the batch number. This is the number of the batch being sent to the carrier. Any value between 0001 and 9999 is acceptable. This must match the batch number in BA0 field 4.
YA0 field 5, positions 26 - 31, is the batch identifier. This field is used to communicate information between provider and carrier for problem batches.
YA0 field 6, positions 32 - 40, is the provider tax ID number. This field simply transmits the provider's tax ID number to the carrier. This can either be an EIN number or a SSN.
YA0 field 7, positions 41 - 46, is reserved space. This is unused record space that is being reserved for future use. As of this article, this field is still not in use.
YA0 field 8, positions 47 - 53, is the batch service line count. This field transmits the number of line items to the carrier that are contained in the whole batch.
YA0 field 9, positions 54 - 60, is the batch record count. This field tells the carrier how many records are contained in the batch.
YA0 field 10, positions 61 - 67, is the batch claim count. This field tells the carrier how many claims are contained in the batch.
YA0 field 11, positions 68 - 76, is the batch total charges. This field tells the carrier what the total charges to them are in the whole batch.
YA0 field 12, positions 77 - 32, is filler national and must be filled with spaces.
This concludes our medical billing review of the YA0 batch trailer record.
Michael Russell Your Independent guide to Medical Billing |
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