Errors identified for
business level edits performed prior to the SUBSCRIBER LOOP (2000B) will result
in immediate file failure at that point. When this occurs, no further editing
will be performed beyond the point of failure.
The billing provider must be associated with an approved electronic submitter.
Claims submitted for billing providers that are not associated to an approved
electronic submitter will be rejected
The maximum number of characters to be submitted in any dollar amount field is
seven characters. Claims containing a dollar amount in excess of 99,999.99 will
be rejected.
Medicare does not support the submission of foreign currency. Claims containing
the 2000A CUR segment will be rejected
Claims that contain percentage amounts with values in excess of 99.99 will be
rejected
For the exception of the CAS segment, all amounts must be submitted as positive
amounts. Negative amounts submitted in any non-CAS amount element will cause
the claim to be rejected.
Claims that contain percentage amounts cannot exceed two positions to the left
or the right of the decimal. Percent amounts that exceed their defined size
limit will be rejected
Contractor name will convert all lower case characters submitted on an inbound
837 file to upper case when sending data to the Medicare processing system.
Consequently, data later submitted for coordination of benefits will be
submitted in upper case.
