NOTE: Providers are not required to include the reference data listed in the rule but are encouraged to include all data elements that are readily available. Additionally, the lists of data elements in the rules are not prohibitive or exhaustive.
No. The list of data elements is recommended to assist with reassociation. The data elements should only be sent, if available, to the provider at the time of submissions. The lists of data elements in the rules are not prohibitive or exhaustive.
No. The CORE-required Minimum Data Elements regarding labels and descriptions indicate that the data could be originating within the provider’s system or the payer’s system. As such, if an Auth ID is not available when the attachment is sent, it is not required.
No. The data does not need to conform to X12 data element naming conventions and as such, do not need to correspond to those X12 data elements as it is not an X12 transaction.
No. If the information is not available, it is not required.
No. If an entity’s internal document management system is not used for holding and processing attachments, it is not subject to the 64 MB minimum size requirement.
Yes. Multiple attachments can be sent within a single X12 v6020 275.
The requirement to support a minimum of 64MB applies to the entire content of the BDS segment of the X12 v6020 275, not per loop. Please note, this requirement is only a floor, not a ceiling, meaning that organizations can choose to accept more than 64MB of data. Organizations must accept a minimum of 64MB.
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