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Troubleshooting EDI Reporter835

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Overview

Decipher error messages received when using the TIER Electronic Data Interfaces (EDI) and when running EDI input files through Reporter835.

Details

Are you a billing client using Electronic Data Interfaces (EDI) and receiving an error message?

Have you been receiving EDI input files and running them through Reporter835 and coming across a message that you’re not sure what it means?   Hopefully this will help you decipher that message.

 

Reporter_835.png

When you run Reporter835 and the message that appears in the NextPayorPlan is UNKNOWN.  This means that particular SubmitterID cannot be matched to a chargeslip. Generally, that means the chargeslip information is not in the SQL database tables. 

        

There are 2 things that should be looked at to determine the cause:

 

  • The chargeslip information in the EDI tables does not match the actual chargeslip information.

 

       There are several tables that can be checked to verify if the chargeslips had been

                    loaded. 

      

                EDI_835_CLP   -  this contains the chargekey

                EDI_835_SVC   - this contains the Medical ProcID, ClaimID and SvcID

                EDI_835_REF  

 

These tables are the main database tables to check to determine if the chargeslip payments had been processed by Reporter835.

 

  • The chargeslip information was not on the EDI input file.

 

If they do not appear in the database tables then you need verify the payments are on the EDI file that was imported to Reporter835.  

 

If you do not currently have EDI interfaces, but are interested in learning more about this, please contact Tom Brefeld (248-726-9004) for more information on setup and training.