Medical Billing - AA0 Record Fields 19 through 33

By: Michael Russell

If you've been following our series on electronic billing formats for medical billing, this is the last part of the AA0 record for NSF 3.01 format, covering fields 19 through 33. While this record probably contains less info that any other record in the NSF specifications, it is one of the most critical because it identifies the person who is submitting the claim. Without this info, the insurance carrier wouldn't know who to pay the money to.

Picking up with field 19, which covers positions 244 - 248, is the national version code. This is the code that tells the carrier which version of the NSF specs are being sent. This is very important because without knowing what version is being sent, they won't know how to process the claim. Leaving this blank or worse, putting in the wrong version, will surely get your claim denied. Field 20 is the local version code and in most cases, this is either blank or the same as field 19.

Field 21, in positions 254 - 257, is the Test/Production indicator. This tells the carrier if the claim being sent is for testing purposes or an actual claim that needs to be paid on. We'll cover this process in more detail in another article. For now, you just need to know that after testing is complete you must change this code to production.

Field 22 is the password used to get into the carrier's system. Each carrier will designate a password for each provider to use. This makes sure that only authorized people enter the system. This helps to reduce fraud.

Field 23, position 266, is the retransmission status. This field is not used in most cases but in instances where it is used, it is to designate if the claim is being retransmitted or resubmitted.

Field 24 is not used to we'll skip right over to field 25 which is Vendor Applications Category. This field basically tells the carrier what category the vendor falls under since many different types of vendors are allowed to submit claims. Some carriers will allow this to be blank as it's not a very important field.

Fields 26 and 27 have to do with the vendor software itself. This is important since there are so many types of claims and software made for them, such as DME claims. The carrier needs to know what type of software is being used.

Field 28, position 291, is the COB or coordination of benefits indicator. This is used for COB billing. Most carriers require this field.

Fields 29 and 30 are the process from and to dates. These dates are critical to this process because the carrier needs to know what dates these claims cover to determine how and if they are paid.

Field 31 is the acknowledgment request field. This is used to tell the carrier if an acknowledgment that the claims were received should be sent back to the vendor. This way, the vendor will know if at least the claims went through or not.

Field 32 is the date of receipt field. This transmits the date that the claims were received.

Field 33 is called national filler. This is one of those very strange fields that nobody really understands. It MUST be left blank. If anything is put into this field, the claims will be denied. This is usually done to make sure that no other format is being sent, sort of like a safeguard.

In our next article, we'll begin our examination of the BA0 record.