guides:claim-rules:claim-note-auto-add
Table of Contents
Claim Note Auto-Add
Automatically add NTE (note) segments to claims for specific payers.
Applies to: Professional (837P), Institutional (837I), Dental (837D)
When to Use This
- A payer requires a specific note on all claims (e.g., contract reference, special instructions)
- You need to add certification or third-party notes to claims
- A payer requires a note for specific claim scenarios
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 |
| Note Qualifier | No | The NTE segment qualifier code. Defaults to “ADD” if blank |
| Note Text | Yes | The actual note content (max 80 characters) |
| Notes | No | Your reference notes (not the same as note text — this is for internal use) |
Common Note Qualifiers
| Qualifier | Description |
|---|---|
| ADD | Additional Information |
| CER | Certification Narrative |
| DCP | Goals, Rehabilitation Potential, or Discharge Plans |
| DGN | Diagnosis Description |
| TPO | Third Party Organization Notes |
Examples
Example 1: Contract Reference Note
Add a contract reference number to all Aetna claims.
| Field | Value |
|---|---|
| Payer Number | 60054 |
| Note Qualifier | ADD |
| Note Text | CONTRACT REF: AET-2026-MEDICAL-001 |
Example 2: Certification Note
Add a certification note for a specific payer.
| Field | Value |
|---|---|
| Payer Number | 00882 |
| Note Qualifier | CER |
| Note Text | SERVICES MEDICALLY NECESSARY PER DR SMITH |
What Happens on the Claim
- An NTE segment is added to Loop 2300 (Claim Level) with the qualifier and text
- Duplicate notes are not added — if an NTE with the same qualifier and text already exists, it's skipped
- A note is added to the claim's internal notes
- Shows in Applied Validation Modules as “ClaimNoteAutoAddModule”
guides/claim-rules/claim-note-auto-add.txt · Last modified: by brad.sharp