Yes. Multiple attachments can be sent within a single X12 v6020 275.
If an entity has an internal management system that is not used for attachments, is it still subject to the 64 MB size minimum?
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.
Are all the data elements included in the CORE-require Minimum Data Elements specified in the non-X12 method section of the CAQH CORE Attachments Claims Data Content Rules required if the information is not available to the provider?
No. If the information is not available, it is not required.
Do the CORE-required Minimum Data Elements specified in the non-X12 method section of the CAQH CORE Attachments Claims Data Content Rules need to correspond to X12 data elements?
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.
Will an ‘Auth # ID’ be required at the time the X12 275 attachment or additional documentation is sent?
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.
If a provider does not send all data elements listed in the CAQH CORE Attachments Claims Data Content Rules to assist with reassociation, can the health plan request that the provider send the data elements listed in the rule?
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.
The common reference data lists represent commonly available data that, after several reviews, the Attachments Advisory Group and Attachments Subgroup participants (including providers, health plans, and vendors) ranked most useful in assisting document management systems with reassociation of an attachment to its original claims submission.