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Enable Pricing/Re-Pricing Information - Registry Setting

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Avatar PM > Billing > Electronic Billing > All 837 Submissions

'Y' enables the following fields:

  • Pricing/Re-Pricing Methodology (2300/2400-HCP-01), and Pricing/Re-Pricing Organization Identifier (2300/2400-HCP-04) fields in Service Fee Maintenance form.

  • Select Loops To Include Pricing/Re-Pricing Information (HCP) in the Guarantor/Program Billing Defaults form (837 Professional, and 837 Institutional sections).

When pricing/re-pricing information is included in the Claim Information (2300) segment:

  • The Pricing/Re-Pricing Methodology (2300-HCP-01), and Pricing/Re-Pricing Organization Identifier (2300-HCP-04) segments populate based on the first service in the Claim Information (2300) segment that includes these fields.

  • The Pricing/Re-Pricing Allowed Amount (2300-HCP-02) segment will populate with sum of the Pricing/Re-Pricing Allowed Amount (2400-HCP-02) for services included in the Claim Information (2300) segment.

When pricing/re-pricing information is included in the Service Line (2400) segment:

  • The Pricing/Re-Pricing Methodology (2400-HCP-01), and Pricing/Re-Pricing Organization Identifier (2400-HCP-04) segments will populate with pricing/re-pricing information entered in the Service Fee Maintenance form for the service.

  • The Pricing/Re-Pricing Allowed Amount (2400-HCP-02) segment will populate with total service charge.

'N' disables these fields and the associated logic.