Solving the Problem of Paper Claims with Bad Payer Addresses

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Gavin Walker
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Solving the Problem of Paper Claims with Bad Payer Addresses

Post by Gavin Walker » Tue Nov 09, 2010 6:27 pm

Solving the Problem of Paper Claims with Bad Payer Addresses
Payer ID: PAPER
Date Range: Effective Immediately
Details: The Problem - Paper Claims with Bad Payer Addresses

Some Payers still only accept Paper claims. When Capario receives claims electronically, with Payer ID (PAPER) for these Payers, they are printed to paper and mailed to the payer.

If those claims have an incorrect address:
  • • It wastes paper
    • Some claims are delivered to a real, but unauthorized, address. PHI may be exposed.
    • The claims can be rejected
    • The claims may not get paid and revenue is lost
Capario's Solution

In an effort to prevent these possible PHI violations, Capario has implemented a new front-end rejection process for Payer ID (PAPER).

Capario has created a table of "bad" addresses based on:
  • • Notifications from those who received a paper claim that was not theirs. It was delivered to someone other than the payer.
    • Paper claims returned to Capario as undeliverable.
Before a claim is printed to paper, the address will be verified against Capario's list of known bad addresses. Claims identified with a bad address, are converted to payer ID (PAPBA) and rejected with this message: INVALID PAPER PAYER ADDRESS

Submitter Actions:
To avoid rejections, verify that claims to Payer ID (PAPER) contain the correct, active, Payer address.
Sincerely,

Capario Production Team
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

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