HIPAA: Electronic Claims with Paper Attachments Now Available
May 23, 2005Providers can now link paper attachments to 837 v.4010A1 electronic claim submissions. The Department of Health Care Services (DHS) is introducing this new functionality to allow providers to submit claim forms electronically and mail in their attachments. To utilize this new process, providers must be authorized to bill 837 v.4010A1 electronic claims. The process includes an Attachment Control Form (ACF), which is used as a coversheet for the supporting paper attachments. The ACF has a pre-printed unique Attachment Control Number (ACN), which submitters input on their electronic claim submission in a specified field. Providers submit the electronic claim and mail the ACF along with the paper attachments to Medi-Cal. Medi-Cal then links the paper attachments to the appropriate electronic claim utilizing the unique ACN. Provider/submitters have a maximum of 30 calendar days to submit the ACF and paper attachments to support the electronic claim.
Providers authorized to bill 837 v.4010A1 electronic claims can begin using this new process by obtaining a supply of the necessary ACFs and ACF envelopes. Supplies can be ordered by calling the Telephone Service Center (TSC) at 1-800-541-5555. To learn more about this new process, review the Billing Instructions found in the 837 v.4010 Companion Guide.
Additional manual replacement pages will be published in future Med-Cal Updates.
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