This article will walk through creating a Claim Format configuration to always send the D8 qualifier in the Loop 2400, segment DTP*472 for Crisis Stabilization procedures since the claim will be denied if the date format indicates the service spanned more than one day.
- Click the Search icon.
- Type Claims Format into the search bar.
- Click to select Claims Format Configuration(s) (Administration).
The Claim Format Configuration(s) screen will open.
- Filter as appropriate if needed.
- Click the Claim Format ID hyperlink for the MH HIPAA 837P Professional.
- Click the Rules tab.
- In the Data Source dropdown menu, select Other.
- Enter “D8″ into the textbox to the right of the Data Source field.
- This tells SmartCare to use the D8 format regardless of the date range associated with the service being billed.
- In the Data Values dropdown menu and select Other.
- In the Format Fields dropdown menu, select 2400 – DTP-472-02 – Service Date Format Qualifier.
- In the Rules Setup section, click the Procedure Code(s) button.
- Type Crisis Stabilization to narrow down the procedure codes
- In the Select Procedure Code(s) pop-up, click the checkboxes for the Crisis Stabilization procedure codes.
- Click Save and Click Close.
- Click Insert.
- The new rule will drop into the Rule List grid.
- Click Save.
