ClaimRev Support Documentation

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====== Filing Indicator Override ======

Override the claim filing indicator code (SBR09) on claims. This is a common rejection reason when the wrong filing indicator is sent to a payer.

**Applies to:** Professional (837P), Institutional (837I), Dental (837D)

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===== When to Use This =====

  * A payer rejects claims with "invalid filing indicator" or similar error
  * Your source system sends the wrong filing indicator for a specific payer
  * You need to change the filing indicator from one value to another per payer

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===== Fields =====

^ Field ^ Required ^ Description ^
| Start Date | Yes | When this rule becomes active |
| End Date | No | When this rule expires |
| Payer Number | No | Only apply for a specific payer. Blank = all payers |
| Original Filing Indicator | No | Only override if the current value matches. Blank = override regardless of current value |
| New Filing Indicator | Yes | The filing indicator code to set |
| Notes | No | Your reference notes |

==== Common Filing Indicator Codes ====

^ Code ^ Description ^
| CI | Commercial Insurance Co. |
| MB | Medicare Part B |
| MC | Medicaid |
| OF | Other Federal Program |
| BL | Blue Cross/Blue Shield |
| CH | CHAMPUS (TRICARE) |
| VA | Veterans Affairs Plan |
| WC | Workers' Compensation |
| AM | Automobile Medical |
| HM | Health Maintenance Organization (HMO) |
| ZZ | Mutually Defined |
| 09 | Self-Pay |
| 11 | Other Non-Federal Programs |
| 12 | Preferred Provider Organization (PPO) |
| 13 | Point of Service (POS) |
| 14 | Exclusive Provider Organization (EPO) |
| 15 | Indemnity Insurance |
| 16 | Health Maintenance Organization (HMO) Medicare Risk |
| 17 | Dental Maintenance Organization |

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===== Examples =====

=== Example 1: Fix Filing Indicator for BCBS ===

BCBS rejects claims when the filing indicator is "CI" — they require "BL".

^ Field ^ Value ^
| Payer Number | 00621 |
| Original Filing Indicator | CI |
| New Filing Indicator | BL |

=== Example 2: Set Medicare Filing Indicator ===

All Medicare claims should have filing indicator "MB" regardless of what's on the claim.

^ Field ^ Value ^
| Payer Number | 00882 |
| New Filing Indicator | MB |

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===== What Happens on the Claim =====

  - Reads the current filing indicator from the SBR segment (element 9) in Loop 2000B
  - If Original Filing Indicator is set, only changes it if the current value matches
  - Sets the new filing indicator value
  - A note is added: "Claim filing indicator changed from {old} to {new}"
  - Shows in Applied Validation Modules as "ClaimFilingIndicatorOverrideModule"

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