====== 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) ---- ===== 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 ---- ===== 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 | ---- ===== 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 | ---- ===== 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" ---- **[[guides:claim-rules|← Back to Claim Rules Engine]]**