ClaimRev Support Documentation

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====== Subscriber ID Override ======

Modify subscriber/member IDs on claims. Strip dashes or spaces, add prefixes or suffixes, or replace the ID entirely.

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

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

  * A payer rejects claims because the member ID has dashes (e.g., "123-456-789" should be "123456789")
  * A payer requires a specific prefix on all member IDs (e.g., "WPA" + member ID)
  * You need to strip spaces from member IDs that come in with extra whitespace
  * A payer's member ID format changed and you need to transform the old format

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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 |
| Match Pattern | No | Only modify IDs that **contain** this text. Blank = apply to all IDs. Example: entering "WPA" will only match IDs like "WPA12345" |
| Replacement Value | No | Replace the entire ID with this value. If set, this overrides strip/prefix/suffix |
| Strip Dashes | No | Remove all dashes (-) from the member ID |
| Strip Spaces | No | Remove all spaces from the member ID |
| Prefix to Add | No | Text to prepend to the member ID |
| Suffix to Add | No | Text to append to the member ID |
| Notes | No | Your reference notes |

==== Processing Order ====

When multiple options are set, they apply in this order:
  - Strip dashes (if checked)
  - Strip spaces (if checked)
  - If **Replacement Value** is set → replaces the entire ID
  - Otherwise → applies Prefix + current ID + Suffix

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===== Examples =====

=== Example 1: Strip Dashes for Aetna ===

Aetna rejects claims with dashes in the member ID.

^ Field ^ Value ^
| Payer Number | 60054 |
| Strip Dashes | ✓ Checked |

Result: "123-456-789" becomes "123456789"

=== Example 2: Add Prefix for Medicaid ===

State Medicaid requires "MCD" prefix on all member IDs.

^ Field ^ Value ^
| Payer Number | 77043 |
| Prefix to Add | MCD |

Result: "12345678" becomes "MCD12345678"

=== Example 3: Replace ID Entirely ===

A specific payer always needs the same subscriber ID format.

^ Field ^ Value ^
| Payer Number | 00621 |
| Match Pattern | WPA |
| Replacement Value | NEWID999 |

Result: Any ID containing "WPA" (like "WPA12345") becomes "NEWID999"

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

  - The subscriber ID in Loop 2010BA (Subscriber) NM1 element 9 is modified
  - A note is added to the claim documenting the change
  - Shows in Applied Validation Modules as "SubscriberIdOverrideModule"

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