Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server FAQ
Guidance for FAQ regarding Edge Server Operations and Data Submission - Other
Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server
Question: If a claim is finalized and adjusted within the same reporting period, do issuers send the original claim, void and replace, or only submit the replacement record?
Answer: Issuers can either submit each claim transaction or submit a final claim transaction based on the business need. If an issuer chooses to submit each claim transaction, then they will need to ensure that the proper void/replace indicators and date/time stamps are included in the file submission. If an issuer chooses to submit a final claim transaction, they will need to ensure that all relevant data, such as full paid amounts and all diagnoses, are included in the file submission.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 23, 2013
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